The most common cause of mortality from congenital lung malformations is which condition?

• A. Meconium aspiration syndrome
• B. Persistent pulmonary hypertension
• C. Pulmonary air leak
• D. Neonatal respiratory distress syndrome

Answer: (B)

In congenital lung malformations, death is most often driven by persistent pulmonary hypertension. After birth, the normal drop in pulmonary vascular resistance is essential for blood to flow through the lungs for oxygenation. When this drop does not occur effectively in these malformations, pulmonary resistance remains high, causing right-to-left shunting through the ductus arteriosus and foramen ovale. This shunting bypasses the lungs, leading to severe hypoxemia and organ injury, which is a major contributor to mortality.

While other issues like meconium aspiration, surfactant deficiency causing neonatal respiratory distress syndrome, or pulmonary air leaks can be serious complications, they are not the predominant cause of death linked specifically to congenital lung malformations.