A newborn that is cyanotic at rest may have what condition?

A newborn who is cyanotic at rest often indicates a significant issue with oxygenation or blood flow, which can be attributed to various medical conditions. In this scenario, choanal atresia is a condition where the nasal passage is blocked, which can lead to difficulty breathing, especially in newborns who are obligate nasal breathers. When the airway is obstructed, it can cause a lack of adequate airflow and ventilation, leading to cyanosis.

Cyanosis, which presents as a bluish discoloration of the skin, signifies that the infant is not getting enough oxygen. This can be particularly problematic when the baby is at rest, as it suggests that the infant is unable to compensate for the airway obstruction through increased effort, leading to decreased oxygen saturation.

In contrast, congenital heart defects and conditions like respiratory distress syndrome or pneumothorax, while they can also cause cyanosis, often present with additional symptoms such as increased work of breathing, grunting, retractions, or an overall unstable clinical picture. Thus, choanal atresia stands out as specifically linked to a structural blockage that can lead to cyanosis at rest due to its direct impact on the newborn's ability to breathe effectively.