Review Question - QID 109294

A newborn male is evaluated in the neonatal intensive care unit 1 minute after birth. He was born at 41 weeks gestation to a 29-year-old primigravid via vaginal delivery. The pregnancy was uncomplicated and the patient’s mother noted that the amniotic fluid was dark and cloudy. Upon delivery, the patient had increased work of breathing and a weak cry. The patient’s birth weight is 3946 g (8 lb 11 oz). His temperature is 97.7°F (36.5°C), blood pressure is 66/43 mmHg, pulse is 149/min, and respirations are 74/min. The patient has nasal flaring and intercostal retractions. He has notable abdominal breathing with a barrel-shaped chest and he has central cyanosis. The patient's chest radiograph can be seen in Figure A. Which of the following is the most likely cause of this patient's symptoms?