**Question:** The criteria for 'at risk' infant include the following except -

A. Premature birth
B. Congenital malformation
C. Transient tachypnea of the newborn (TTN)
D. Hypotension

**Core Concept:** Transient tachypnea of the newborn (TTN) is a respiratory condition in infants, characterized by increased respiratory rate without significant respiratory distress. It occurs due to delayed clearance of residual amniotic fluid from the lungs, which leads to increased work of breathing.

**Why the Correct Answer is Right:** Hypotension is not specific to 'at risk' infants, rather it is a general term for low blood pressure in any age group. While premature birth and congenital malformation are important risk factors for certain conditions and can contribute to morbidity and mortality in infants, hypotension does not fit the criteria for an 'at risk' infant.

**Why Each Wrong Option is Incorrect:**

A. Premature birth: Premature infants are indeed at increased risk due to immature respiratory and cardiovascular systems, leading to respiratory distress, hypotension, and other complications. However, premature birth alone is not a sufficient criterion for an 'at risk' infant, as many infants born at term can also be considered at risk for other reasons (e.g., congenital malformation).

B. Congenital malformation: A congenital malformation refers to an abnormal development of an organ or system during fetal life. While certain malformations increase the risk for an infant, hypotension is not an immediate consequence or risk factor associated with congenital malformations.

**Clinical Pearl:** Transient tachypnea of the newborn (TTN) is a specific respiratory condition in infants related to delayed lung clearance, which increases the risk of an at-risk infant but does not apply to the other options. TTN is a clinical entity that needs to be considered in infants presenting with increased respiratory rate without significant distress.