<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 5-day-old newborn is brought into the pediatrician by her parents for new-onset vaginal bleeding. This morning, when the patients father was changing her diaper he noticed blood and white vaginal discharge. The patient was born at 39 weeks to a G1P1 mother who has well-controlled type 1 diabetes. The pregnancy and the vaginal delivery were unremarkable. Apgar scores were 89. The mother is breast-feeding and reports that the patient is feeding well. The patients temperature is 99F 37.2C, blood pressure is 7048 mmHg, pulse is 134min, and respirations are 38min with an oxygen saturation of 98 on room air. She has lost 5 of her weight since birth. Physical examination notes neonatal acne, enlarged breasts, swollen labia, white vaginal discharge, and evidence of blood in the vaginal opening. Which of the following is the most likely cause of the patients symptoms?? A: Congenital adrenal hyperplasia, B: External trauma, C: Genitourinary infection, D: Maternal estrogen withdrawal, E: Yolk sac tumor,  <response>: This is a clinical vignette about a 5-day-old newborn girl presenting with vaginal bleeding and discharge. The key findings in the vignette are: - 5-day-old newborn - Vaginal bleeding and white discharge noticed by father - Born at 39 weeks to diabetic mother, otherwise uncomplicated pregnancy and delivery- Well-appearing, afebrile - Physical exam shows neonatal acne, breast enlargement, labial swelling, vaginal discharge and bleedingThe most likely diagnosis is maternal estrogen withdrawal. Neonatal estrogen withdrawal can occur after birth due to abrupt cessation of maternal estrogen exposure. This leads to vaginal bleeding, breast enlargement, and labial swelling, as described in this infant. Congenital adrenal hyperplasia is unlikely as it would present with ambiguous genitalia at birth. External trauma, genitourinary infection, and yolk sac tumor would not explain the physical exam findings.D: Maternal estrogen withdrawal 