A nurse is completing a health history for a client who is at 6 weeks of gestation. The client informs the nurse that she smokes one pack of cigarettes per day. The nurse should advise the client that smoking places the client's newborn at risk for which of the following complications?

A. Congenital heart defects: While some environmental exposures may increase the risk of congenital anomalies, smoking is more closely linked with placental and growth complications rather than structural heart defects in the fetus. B. Hearing loss: Hearing loss in newborns is commonly associated with infections, genetic conditions, or exposure to ototoxic medications. Maternal smoking has not been strongly linked to this outcome in pregnancy. C. Type 1 diabetes mellitus: Type 1 diabetes is an autoimmune condition with a strong genetic component. Smoking during pregnancy does not contribute to the development of this chronic disease in infants. D. Intrauterine growth restriction: Nicotine causes vasoconstriction and reduces placental perfusion, leading to decreased oxygen and nutrient delivery to the fetus. This significantly increases the risk of intrauterine growth restriction and low birth weight.