Materiały źródłowe

• #1 Neonatal Respiratory Distress Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560779/

  Neonatal respiratory distress syndrome (RDS) occurs from a deficiency of surfactant, due to either inadequate surfactant production, or surfactant inactivation in the context of immature lungs. Prematurity affects both these factors, thereby directly contributing to RDS. […] It is essential to review fetal lung development and surfactant production to understand the etiology of RDS. The normal process of fetal lung development occurs in stages, known as embryonic, pseudo glandular, canalicular, saccular, and alveolar stages. […] The pulmonary surfactant covers the inner lining of normal alveoli. In the fetus, however, the developing alveoli are filling with fetal lung fluid, which does not contribute to gas exchange. During fetal life, surfactant production begins in the alveolar type 2 cells around 20 weeks gestation.

• #1 Respiratory Distress Syndrome (RDS) in Newborns: Diagnosis & Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/respiratory-distress-syndrome-newborn

  Respiratory distress syndrome (RDS) occurs in babies born early (premature) whose lungs are not fully developed. […] RDS is caused by the baby not having enough surfactant in the lungs. Surfactant is a liquid made in the lungs at about 26 weeks of pregnancy. […] Those at greater risk are: Siblings that had RDS, Twin or multiple births, C-section (cesarean) delivery, Mother that has diabetes, Infection, Baby that is sick at the time of delivery, Cold, stress, or hypothermia. Baby cannot keep body temperature warm at birth.

• #1 Respiratory Distress Syndrome in Neonates – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-problems-in-neonates/respiratory-distress-syndrome-in-neonates

  Respiratory distress syndrome is caused by pulmonary surfactant deficiency in the lungs of neonates, most commonly in those born at 37 weeks gestation. Risk increases with degree of prematurity. […] Surfactant is not produced in adequate amounts until relatively late in gestation (34 to 36 weeks); thus, risk of respiratory distress syndrome (RDS) increases with greater prematurity. Other risk factors include multifetal pregnancies, maternal diabetes, and being a White male. […] Rare cases are hereditary, caused by mutations in surfactant protein (SP-B and SP-C) and ATP-binding cassette transporter A3 (ABCA3) genes.

• #1 Neonatal Respiratory Distress Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560779/

  Monozygotic twins have a higher incidence of RDS compared to dizygotic twins, and an increased incidence of RDS has also been reported in families, thus supporting an underlying genetic predisposition. […] As the most common cause of respiratory distress in premature infants, RDS occurs in about 24,000 infants born in the United States annually. It is also the most common complication of prematurity leading to significant morbidity in late preterm neonates and even mortality in very low birth weight infants. […] Neonatal respiratory distress syndrome is caused by surfactant deficiency, especially in the context of immature lungs. The deficiency of surfactant increases the surface tension within the small airways and alveoli, thereby reducing the compliance of the immature lung. […] The pathophysiology of RDS can be described using LaPlace law, denoted as: P=2T/R where P is pressure, T is surface tension, and R is the radius.

• #1 Respiratory Distress Syndrome: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/976034-overview

  The greatest risk factors for respiratory distress syndrome in infants are prematurity (although the syndrome does not occur in all premature newborns) and low birth weight. […] Maternal diabetes, White race, male sex, late preterm delivery, cesarean delivery, delivery without labor, and perinatal hypoxia, asphyxia, and ischemia are other risk factors. […] In premature infants, respiratory distress syndrome develops because of impaired surfactant synthesis and secretion leading to atelectasis, ventilation-perfusion (V/Q) inequality, and hypoventilation with resultant hypoxemia and hypercarbia. […] The relative deficiency of surfactant decreases lung compliance and functional residual capacity, with increased dead space. […] Hypoxia, acidosis, hypothermia, and hypotension may impair surfactant production and/or secretion.

• #1 Infant Respiratory Distress Syndrome (IRDS)

  https://patient.info/doctor/infant-respiratory-distress-syndrome

  Infant respiratory distress syndrome (IRDS) is caused by the inadequate production of surfactant in the lungs. Surfactant is normally produced by type II pneumocytes and has the property of lowering surface tension. […] Inadequate surfactant production causes air sacs to collapse on expiration and greatly increases the energy required for breathing. […] Secondary surfactant deficiency may occur in infants as a result of: Intrapartum asphyxia. […] The incidence of IRDS decreases with: The use of antenatal steroids. […] The incidence and severity are related inversely to the gestational age of the infant; a 2012 study showed 98% of babies born at 24 weeks had IRDS, while at 34 weeks, the incidence was 5%, and at 37 weeks was less than 1%. […] Antenatal corticosteroids (dexamethasone) accelerate fetal surfactant production and lung maturation. They have been shown to reduce infant respiratory distress syndrome, intraventricular haemorrhage and mortality by 40%.

• #1 Neonatal respiratory distress syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001563.htm

  Neonatal respiratory distress syndrome (RDS) is a problem often seen in premature babies. The condition makes it hard for the baby to breathe. […] Neonatal RDS occurs in infants whose lungs have not yet fully developed. […] The disease is mainly caused by a lack of a slippery substance in the lungs called surfactant. This substance helps the lungs fill with air and keeps the air sacs from deflating. Surfactant is present when the lungs are fully developed. […] Neonatal RDS can also be due to genetic problems with lung development. […] Most cases of RDS occur in babies born before 37 to 39 weeks. The more premature the baby is, the higher the chance of RDS after birth. The problem is uncommon in babies born full-term or later (39 weeks or after). […] Other factors that can increase the risk for RDS include: A brother or sister who had RDS, Diabetes in the mother, Cesarean delivery or induction of labor before the baby is full-term, Problems with delivery that reduce blood flow to the baby, Multiple pregnancy (twins or more), Rapid labor.

• #1 Risk factors for respiratory distress syndrome in full-term neonates

  https://www.e-jyms.org/journal/view.php?doi=10.12701/yujm.2018.35.2.187

  Respiratory distress syndrome (RDS) is a one of the most common cause of respiratory morbidity and mortality in neonates. This study was conducted to investigate the risk factors for RDS in full-term neonates. […] The risk factors for RDS in full-term neonates were identified as male sex, cesarean section, and multiparity. Further studies involving more institutions are needed to clarify the risk factors for RDS in full-term infants. […] Neonatal respiratory distress syndrome (RDS) is one of the major causes of respiratory failure and neonatal death in premature infants and is caused by a lack of pulmonary surfactant due to fetal lung immaturity. […] In this study, it was found that male sex, cesarean section, and multiparity had a statistically significant association with an increased incidence of RDS.

• #1 Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt | Annals of Global Health

  https://annalsofglobalhealth.org/articles/10.5334/aogh.2739

  Respiratory diseases in newborns are considered major causes of neonatal morbidity and mortality especially in developing countries. Its causes are diverse and require early detection and management. […] The most common detected respiratory diseases were respiratory distress syndrome (RDS; 49.6%), transient tachypnea of newborn (TTN; 22%), neonatal pneumonia (17.2%) and meconium aspiration syndrome (MAS; 6.21%). Premature rupture of membrane (PROM), maternal diabetes and fetal prematurity had the highest risk factors for respiratory diseases occurrence in neonates. […] Respiratory distress syndrome carried the highest risk of mortality and TTN carried the highest survival rate. […] Certain risk factors increase the susceptibility for neonatal respiratory diseases as prematurity, meconium aspiration, caesarian section delivery, gestational diabetes, maternal chorioamnionitis, and prenatal ultrasonographic findings, such as oligohydramnios and structural lung disorders.

• #1 Respiratory Distress Syndrome: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/976034-overview

  A chronic process often ensues in infants who are extremely immature and critically ill and in infants born to mothers with chorioamnionitis, resulting in BPD. […] The hydrophobic SP-B and SP-C are essential for lung function and pulmonary homeostasis after birth. […] SP-B deficiency is an inherited deficiency caused by a pretranslational mechanism implied by the absence of messenger ribonucleic acid (mRNA). […] Approximately 15% of term infants who die of a syndrome similar to respiratory distress syndrome have SP-B deficiency. […] Mutations in the adenosine triphosphate (ATP)binding cassette gene (ABCA3) in newborns result in fatal surfactant deficiency. […] The incidence of genetic abnormalities of pulmonary surfactant disorders is unknown.

• #1 Unusual Cause of Respiratory Distress in a Term Neonate | Ochsner Journal

  https://www.ochsnerjournal.org/content/22/2/196

  Respiratory distress is a clinical finding often seen in neonates. Common causes of respiratory distress in this population include respiratory distress syndrome, transient tachypnea of the newborn, infection, aspiration, and cardiac etiologies. […] The patient was eventually found to have a variant of a genetic mutation that predisposed the infant to this presentation. […] The patient was eventually found to have a genetic mutation causing surfactant dysfunction, predisposing the infant to this presentation. […] Most of the common underlying etiologies for respiratory distress were ruled out. In view of the patient’s clinical presentation and CT scan, interstitial lung disease was suspected. Genetic studies for surfactant protein mutations were obtained before the patient was transferred. The genetic evaluation was positive for NKX2.1 variance mutation C.190C.

• #1 Infant Respiratory Distress Syndrome (Hyaline Membrane Disease) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/infant-respiratory-distress-syndrome-hyaline-membrane-disease

  HMD occurs when there is not enough of a substance in the lungs called surfactant. Surfactant is made by the cells in the airways and consists of phospholipids and protein. It begins to be produced in the fetus at about 24 to 28 weeks of pregnancy, and is found in amniotic fluid between 28 and 32 weeks. By about 35 weeks gestation, most babies have developed adequate amounts of surfactant. […] Although most babies with HMD are premature, other factors can influence the chances of developing the disease. These include the following: Caucasian or male babies, Previous birth of baby with HMD, Cesarean delivery, Perinatal asphyxia (lack of air immediately before, during, or after birth), Cold stress (a condition that suppresses surfactant production), Perinatal infection, Multiple births (multiple birth babies are often premature), Infants of diabetic mothers (too much insulin in a baby’s system due to maternal diabetes can delay surfactant production), Babies with patent ductus arteriosus.

• #1 Respiratory Distress Syndrome in Newborn

  https://www.picmonic.com/pathways/nursing/courses/standard/medical-surgical-nursing-pathophysiology-296/respiratory-disorders-2154/neonatal-respiratory-distress-syndrome_2265

  Neonatal respiratory distress syndrome (NRDS) is a condition related to fetal lung immaturity in premature infants (37 weeks gestational age) and a lack of surfactant. […] Fetal lung immaturity may lead to the development of neonatal respiratory distress syndrome (NRDS). Premature infants born less than 37 weeks gestational age are at an increased risk of developing NRDS. […] Other causes of NRDS not related to prematurity or of pulmonary origin include sepsis, heart defects, exposure to cold, obstruction of the airway, intraventricular hemorrhage, hypoglycemia, metabolic acidosis, blood loss, and drugs. […] Neonatal respiratory distress syndrome is most commonly caused by a lack of surfactant in the infant’s lungs. Surfactant is a substance that reduces surface tension in the alveoli of the lungs and helps to prevent alveolar collapse. The more premature the newborn, the less surfactant available, thus increasing the likelihood of NRDS.

• #1 Newborn respiratory distress syndrome

  https://www.nhs.uk/conditions/neonatal-respiratory-distress-syndrome/

  Newborn respiratory distress syndrome (NRDS) happens when a baby’s lungs are not fully developed and cannot provide enough oxygen, causing breathing difficulties. It usually affects premature babies. […] NRDS usually occurs when the baby’s lungs have not produced enough surfactant. […] If your baby is born prematurely, they may not have enough surfactant in their lungs. […] Occasionally, NRDS affects babies that are not born prematurely. […] Around half of all babies born between 28 and 32 weeks of pregnancy develop NRDS. […] In recent years the number of premature babies born with NRDS has been reduced with the use of steroid injections, which can be given to mothers during premature labour. […] The steroids stimulate the development of the baby’s lungs. It’s estimated that the treatment helps prevent NRDS in a third of premature births.

• #1 Respiratory Distress Syndrome: Predisposing Factors, Pathophysiology, and Diagnosis | SpringerLink

  https://link.springer.com/10.1007/978-3-319-29489-6_289

  Due to increased survival and new treatment strategies, new phenotypes of respiratory distress syndrome (RDS) have emerged. […] Common preventable cause is elective delivery before full 40 weeks of pregnancy. […] Extremely preterm infants are often affected by intrauterine inflammation, accelerating surfactant maturity. […] Genetic factors predisposing very preterm infants to RDS are intertwined with acquired risks: lack of labor, non-presenting twin, and adverse metabolic environment (e.g., hyperinsulinemia). […] Antenatal steroid, inducing structural maturity and stimulating functional maturity, is the cornerstone of prevention of RDS and the developmental diseases prior to week 34.

• #1 Neonatal respiratory distress syndrome (patient information) – wikidoc

  https://www.wikidoc.org/index.php/Neonatal_respiratory_distress_syndrome_(patient_information)

  Infant RDS occurs in infants whose lungs have not yet fully developed. […] The disease is mainly caused by a lack of a slippery, protective substance called surfactant, which helps the lungs inflate with air and keeps the air sacs from collapsing. This substance normally appears in fully developed lungs. […] Infant RDS can also be the result of genetic problems with lung development. […] The earlier a baby is born, the less developed the lungs are and the higher the chance of Infant RDS. Most cases are seen in babies born before 28 weeks. It is very uncommon in infants born full-term (at 40 weeks). […] In addition to prematurity, the following increase the risk of Infant RDS: A brother or sister who had RDS, diabetes in the mother, cesarean delivery, delivery complications that reduce blood flow to the baby, multiple pregnancy (twins or more), rapid labor. […] The risk of Infant RDS may be decreased if the pregnant mother has chronic, pregnancy-related high blood pressure or prolonged rupture of membranes, because the stress of these situations can cause the infant’s lungs to mature sooner.

• #1 A Parental Guide to Neonatal Respiratory Distress Syndrome (RDS)

  https://womenandchildren.avisena.com.my/health-articles/breathing-easy-navigating-neonatal-respiratory-distress-syndrome-rds/

  Elective caesarean deliveries before labour can increase the risk of RDS in babies, as labour helps in preparing the lungs by promoting surfactant production and clearing fluid. […] Multiples such as twins or triplets are more likely to be born prematurely and at risk for respiratory distress syndrome. Uneven lung maturity can occur due to shared resources in the womb. […] Certain conditions such as perinatal asphyxia and cold stress can lead to delayed production or function of surfactant in full-term babies, causing respiratory difficulties. […] When preterm birth is anticipated, administering corticosteroids to the mother can significantly accelerate foetal lung maturation. Failure to receive this treatment increases the likelihood of RDS. […] Male infants, particularly premature ones, are more prone to RDS than females. This disparity may be linked to slower lung development in male foetuses.

• #1 Respiratory Distress in the Newborn | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/1001/p987.html

  The pathophysiology is complex. Immature type II alveolar cells produce less surfactant, causing an increase in alveolar surface tension and a decrease in compliance. […] Persistent pulmonary hypertension of the newborn occurs when pulmonary vascular resistance fails to decrease soon after birth as with normal transition. The etiology may be idiopathic or secondary to meconium aspiration syndrome, pneumonia or sepsis, respiratory distress syndrome, or transient tachypnea of the newborn. […] Certain congenital malformations can lead to respiratory distress; these include pulmonary hypoplasia, congenital emphysema, esophageal atresia, and diaphragmatic hernia. […] Neurologic disorders such as hydrocephalus and intracranial hemorrhage can cause respiratory distress. […] Metabolic and hematologic derangements (e.g., hypoglycemia, hypocalcemia, polycythemia, anemia) can also cause respiratory symptoms.

• #1 Neonatal respiratory distress syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/neonatal-respiratory-distress-syndrome/

  Neonatal respiratory distress syndrome is caused by impaired synthesis and secretion of surfactant. Risk factors include: […] Maternal diabetes mellitus: leads to fetal insulin, which inhibits surfactant synthesis. […] Cesarean delivery: results in lower levels of fetal glucocorticoids than vaginal delivery, in which higher levels are released as a response to stress from uterine contractions. […] Surfactant deficiency is most likely to occur in preterm infants, because: Surfactant production begins at approximately 20 weeks gestation. […] The lower the lecithin-sphingomyelin ratio, the more likely it is that the lungs are immature. […] Deficiency of pulmonary surfactant. […] Immature respiratory control. […] Elevated pulmonary vascular resistance right-to-left shunting through the foramen ovale and patent ductus arteriosus (bypassing the lungs) pre- and postductal oxygenation gradient (e.g., preductal O2 saturation is often higher than postductal). […] Associated with abnormal prenatal development of or perinatal maladaptation of pulmonary vasculature.

• #1 What causes respiratory distress syndrome? – Campus Vygon Global

  https://campusvygon.com/global/what-causes-respiratory-distress-syndrome/

  The main cause of RDS is an insufficient amount of pulmonary surfactant. The most common etiologic factor is premature birth. The manifestations of the disease are due to the resulting alveolar atelectasis, edema and cellular injury. As a result, serum proteins that inhibit surfactant function leak into the alveolus. The higher water content, immature pulmonary fluid clearance mechanisms, lack of alveolocapillary apposition, and reduced gas exchange surface characteristic of the immature lung also contribute to the disease. […] As mentioned above, one of the most important (if not the most important) triggering factors in the etiology of RDS is prematurity. In general, the incidence and severity of RDS is inversely related to gestational age (the lower the gestational age, the higher the risk of RDS). […] Although a definitive diagnosis of RDS requires pathologic or biochemical documentation of surfactant deficiency, clinicians often use a combination of clinical and radiographic features to diagnose RDS.

• #1 Neonatal Respiratory Distress Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560779/

  The goals of optimal management of neonatal respiratory distress syndrome include decreasing incidence and severity using antenatal corticosteroids, followed by optimal management using respiratory support, surfactant therapy, and overall care of the premature infant. […] There are numerous causes of neonatal respiratory distress syndrome, including transient tachypnea of the newborn, pulmonary air leak disorders (pneumothorax, pneumomediastinum), neonatal pneumonia, meconium aspiration, persistent pulmonary hypertension of the newborn, and the broad categories of cyanotic congenital heart disease and interstitial lung disease. […] Prognosis of infants managed with antenatal steroids, respiratory support, and exogenous surfactant therapy is excellent. Mortality is less than 10%, with some studies showing survival rates of up to 98% with advanced care.

• #1 Respiratory distress syndrome (RDS) in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/respiratory-distress-syndrome-rds-in-neonates

  Respiratory distress syndrome (RDS) is when the neonate has difficulty breathing due to surfactant deficiency at birth. RDS, also known as hyaline membrane disease (HMD), is the dominant clinical problem faced by preterm infants and is directly related to structurally immature and surfactant deficient lungs. […] The greatest risk factor is low gestational age and the development of the disease begins with the impaired synthesis of pulmonary surfactant associated with prematurity. […] The disease is exacerbated by treatable and preventable factors including: cold stress, hypoxia, acidosis, secondary surfactant deficiencies – meconium aspiration syndrome, infant of diabetic mother, pneumonia.

• #1 Table: Causes of Respiratory Distress in Neonates and Infants-Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/multimedia/table/causes-of-respiratory-distress-in-neonates-and-infants

  Respiratory distress syndrome, transient tachypnea of the newborn, meconium aspiration, pneumonia, pneumothorax, congenital diaphragmatic hernia, pulmonary hypoplasia, cystic malformation of the lung, congenital deficiency of surfactant proteins B or C […] Right-to-left shunting with decreased pulmonary flow is less likely than right-to-left shunting or mixing lesions with normal or increased pulmonary flow to manifest with significant respiratory distress.

• #1 The Underlying Causes of Respiratory Distress in Late-Preterm and Full-Term Infants Are Different From Those of Early-Preterm Infants

  https://brieflands.com/articles/ijp-104011

  A diagnosis of neonatal respiratory distress syndrome (RDS) is common among newborns in China. Some late-preterm and full-term (LP/FT) infants with respiratory distress (RD) symptoms but not primary surfactant deficiency are also diagnosed with RDS and given exogenous surfactant replacement therapy (SRT). […] An increasing number of neonatologists have proposed that RD etiologies should be specifically classified to guide clinical treatment. […] Analysis of 1240 infants diagnosed with RDS showed that SRT was less effective in LP/FT infants than in early-preterm (EP) infants. GA 30 weeks and no prenatal corticosteroid use were closely related to RDS severity in EP infants, whereas perinatal infection- and perinatal hypoxia-associated risk factors and a high cesarean rate were closely related to RDS severity in LP/FT infants.

• #1 The Underlying Causes of Respiratory Distress in Late-Preterm and Full-Term Infants Are Different From Those of Early-Preterm Infants

  https://brieflands.com/articles/ijp-104011

  The causes of RD might differ between LP/FT and EP infants, and the diagnosis of RDS might be overused in LP/FT infants. RD in LP/FT infants is more likely related to perinatal infection, perinatal hypoxia, elective cesarean and hereditary factors, which are important causes of neonatal pulmonary edema. […] The etiology of RDS mainly involves developmental immaturity of the lungs. […] Many pediatricians have observed that respiratory distress (RD) in newborn infants is only a symptom that can be caused by many respiratory diseases, including RDS, RDS with additional pathogenic factors, and other factors alone. […] However, due to the lack of standardization of RD diagnosis in China, in actual clinical practice, some of the LP/FT infants with RD but not primary pulmonary surfactant deficiency are also diagnosed with RDS and given exogenous SRT.

• #1 Risk factors for respiratory distress syndrome in full-term neonates

  https://www.e-jyms.org/journal/view.php?number=2409

  Respiratory distress syndrome (RDS) is a one of the most common cause of respiratory morbidity and mortality in neonates. This study was conducted to investigate the risk factors for RDS in full-term neonates. […] The risk factors for RDS in full-term neonates were identified as male sex, cesarean section, and multiparity. Further studies involving more institutions are needed to clarify the risk factors for RDS in full-term infants. […] Neonatal respiratory distress syndrome (RDS) is one of the major causes of respiratory failure and neonatal death in premature infants and is caused by a lack of pulmonary surfactant due to fetal lung immaturity. […] In this study, it was found that male sex, cesarean section, and multiparity had a statistically significant association with an increased incidence of RDS.

• #1

  https://www.ijpediatrics.com/index.php/ijcp/article/view/2897

  Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and neonatal death. […] This study aims at studying the risk factors for developing RDS in term neonates. […] In our study RDS in term neonates was significantly associated with following risk factors like selective cesarean section, male sex, SGA, oligohydramnios, MSAF, severe fetal distress, birth asphyxia, PROM, and maternal-fetal infection. […] Several high-risk factors such as severe birth asphyxia, maternal-fetal infection, PROM, and MSAF were closely correlated with full-term neonatal RDS.

• #1 Respiratory Distress Syndrome of the Newborn | RT

  https://respiratory-therapy.com/public-health/pediatrics/neonatal/respiratory-distress-syndrome-of-the-newborn/

  Respiratory distress syndrome of the newborn (RDS) occurs in premature infants secondary to insufficient surfactant production and structural immaturity of the infants lungs. […] Other etiologies include neonatal infection, often a gram-negative bacteremia and genetic lack of normal surfactant protein production. […] Regardless of the cause of RDS, if not recognized and managed quickly, respiratory distress can escalate to respiratory failure and cardiopulmonary arrest. […] The two major management approaches to prevent the development of RDS are the use of antenatal treatment of women in preterm labor with glucocorticoid hormone to accelerate fetal lung maturation and the early use of surfactant replacement therapy. […] Prophylactic or preventive surfactant administration is defined as endotracheal intubation and surfactant administration to infants at high risk of developing RDS. […] Together with antenatal corticosteroid treatment, the use of prophylactic surfactant has made the greatest contribution to decreasing the incidence of RDS and its associated mortality and morbidity.

• #1 Respiratory Distress Syndrome (RDS) | Birth Injury Lawyers

  https://www.nationalbirthinjurylaw.com/respiratory-distress-syndrome

  Respiratory distress syndrome in babies primarily occurs due to the deficiency of surfactant in the lungs. […] Surfactant is produced in the babys lungs at about 26 weeks of gestation. […] In preterm babies, the lack of surfactant can cause the air sacs to deflate, leading to respiratory distress syndrome. […] Risk factors include: Induction of labor or cesarean section before the baby is full-term, Birth complications that reduce the blood flow to the baby, Rapid labor, Baby is sick at the time of birth, Hypothermia (baby is unable to keep body temperature warm at the time birth), Maternal diabetes, Maternal infection, Twins or multiple pregnancy, A sibling was born with a RDS birth complication. […] It is equally important to focus on any other possible causes of RDS in premature babies, such as infection.

• #1 Genetic Disorders of Neonatal Respiratory Function | Pediatric Research

  https://www.nature.com/articles/pr2001159

  Genetic risk for respiratory distress in infancy has been recognized with increasing frequency in neonatal intensive care units. […] Reports of family clusters of affected infants and of ethnic- and gender-based respiratory phenotypes point to the contribution of inheritance. […] Similarly, different outcomes among gestationally matched infants with comparable exposures to oxygen, mechanical ventilation, or nutritional deficiency also suggest a genetic risk for respiratory distress. […] Examples of inherited deficiency of surfactant protein B in both humans and genetically engineered murine lineages illustrate the importance of identifying markers of genetic risk. […] In contrast to developmental, inflammatory, or nutritional causes of respiratory distress that may resolve as infants mature, genetic causes result in both acute and chronic (and potentially irreversible) respiratory failure.

• #1 Genetic Testing for Neonatal Respiratory Disease

  https://www.mdpi.com/2227-9067/8/3/216

  Sequence variants in the gene (ABCA3) disrupting or limiting production of ABCA3 may therefore cause surfactant deficiency. […] The principal cause of ACD-MPV results from deletions or sequence variants in one allele of the gene encoding the transcription factor, FOXF1. […] Genetic disorders disrupting surfactant function, metabolism, or lung development cause lung disease that is usually progressive. […] Genetic testing is warranted in all neonates with respiratory distress persisting for >48 h that is not adequately explained by history and other laboratory findings yielding a specific diagnosis.

• #1 Newborn respiratory distress syndrome

  https://www.nhs.uk/conditions/neonatal-respiratory-distress-syndrome/

  Most babies with NRDS can be successfully treated, although they have a high risk of developing further problems later in life. […] Babies with NRDS may have bleeding inside their lungs (pulmonary haemorrhage) and brain (cerebral haemorrhage). […] Sometimes ventilation (begun within 24 hours of birth) or the surfactant used to treat NRDS causes scarring to the baby’s lungs, which affects their development. […] If the baby’s brain is damaged during NRDS, either because of bleeding or a lack of oxygen, it can lead to long-term developmental disabilities, such as learning difficulties, movement problems, impaired hearing and impaired vision.

• #1 Respiratory Distress Syndrome (RDS) in Premature Babies – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=respiratory-distress-syndrome-rds-in-premature-babies-90-P02371

  Respiratory distress syndrome (RDS) is a common problem in premature babies. […] RDS occurs when there is not enough surfactant in the lungs. […] An unborn baby starts to make surfactant at about 26 weeks of pregnancy. […] If a baby is premature (born before 37 weeks of pregnancy), he or she may not have made enough surfactant yet. […] The more premature the baby, the higher the risk and the more severe the RDS. […] The baby has a condition called patent ductus arteriosus (PDA). […] Preventing a premature birth is the main way to prevent RDS.

• #1 HIE Multimedia – Neonatal respiratory distress syndrome

  https://adamcertificationdemo.adam.com/content.aspx?productid=117&pid=1&gid=001563

  Taking steps to prevent premature birth can help prevent neonatal RDS. Good prenatal care and regular checkups beginning as soon as a woman discovers she is pregnant can help avoid premature birth. […] The risk of RDS can also be lessened by the proper timing of delivery. An induced delivery or cesarean may be needed. […] Medicines called corticosteroids can help speed up lung development before a baby is born.

• #2 Respiratory distress syndrome (RDS) in preterm neonates: Clinical features and diagnosis – UpToDate

  https://www.uptodate.com/contents/pathophysiology-clinical-manifestations-and-diagnosis-of-respiratory-distress-syndrome-in-the-newborn

  Respiratory distress syndrome (RDS), formerly known as hyaline membrane disease, is a common cause of respiratory distress, morbidity, and mortality in preterm neonates. This disorder is caused primarily by deficiency of pulmonary surfactant in an immature lung. […] Knowledge of the normal fetal lung development is central to understanding the pathophysiology of neonatal RDS, which is due to inadequate surfactant activity resulting from lung immaturity.

• #2 Respiratory Distress Syndrome | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/respiratory-distress-syndrome

  RDS occurs when there is not enough of a substance in the lungs called surfactant. Surfactant is a liquid produced by the lungs that keeps the airways (called alveoli) open, making it possible for babies to breathe in air after delivery. […] When there is not enough surfactant, the tiny alveoli collapse with each breath. As the alveoli collapse, damaged cells collect in the airways and further affect breathing ability. […] The more premature the baby, the higher the risk and the more severe the RDS. […] These include the following: White or male babies, Previous birth of baby with RDS, Cesarean delivery, Perinatal asphyxia, Cold stress (a condition that suppresses surfactant production), Perinatal infection, Multiple births (multiple birth babies are often premature), Infants of diabetic mothers (too much insulin in a baby’s system due to maternal diabetes can delay surfactant production), Babies with patent ductus arteriosus. […] Surfactant replacement with artificial surfactant. This is most effective if started in the first six hours of birth. Surfactant replacement has been shown to reduce the severity of RDS.

• #2 Infant Respiratory Distress Syndrome (Hyaline Membrane Disease) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/infant-respiratory-distress-syndrome-hyaline-membrane-disease

  HMD occurs when there is not enough of a substance in the lungs called surfactant. Surfactant is made by the cells in the airways and consists of phospholipids and protein. It begins to be produced in the fetus at about 24 to 28 weeks of pregnancy, and is found in amniotic fluid between 28 and 32 weeks. By about 35 weeks gestation, most babies have developed adequate amounts of surfactant. […] Although most babies with HMD are premature, other factors can influence the chances of developing the disease. These include the following: Caucasian or male babies, Previous birth of baby with HMD, Cesarean delivery, Perinatal asphyxia (lack of air immediately before, during, or after birth), Cold stress (a condition that suppresses surfactant production), Perinatal infection, Multiple births (multiple birth babies are often premature), Infants of diabetic mothers (too much insulin in a baby’s system due to maternal diabetes can delay surfactant production), Babies with patent ductus arteriosus.

• #2 Respiratory Distress in the Newborn | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/1001/p987.html

  The pathophysiology is complex. Immature type II alveolar cells produce less surfactant, causing an increase in alveolar surface tension and a decrease in compliance. […] Persistent pulmonary hypertension of the newborn occurs when pulmonary vascular resistance fails to decrease soon after birth as with normal transition. The etiology may be idiopathic or secondary to meconium aspiration syndrome, pneumonia or sepsis, respiratory distress syndrome, or transient tachypnea of the newborn. […] Certain congenital malformations can lead to respiratory distress; these include pulmonary hypoplasia, congenital emphysema, esophageal atresia, and diaphragmatic hernia. […] Neurologic disorders such as hydrocephalus and intracranial hemorrhage can cause respiratory distress. […] Metabolic and hematologic derangements (e.g., hypoglycemia, hypocalcemia, polycythemia, anemia) can also cause respiratory symptoms.

• #2 Respiratory Distress Syndrome in Neonates – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-problems-in-neonates/respiratory-distress-syndrome-in-neonates

  Respiratory distress syndrome is caused by pulmonary surfactant deficiency in the lungs of neonates, most commonly in those born at 37 weeks gestation. Risk increases with degree of prematurity. […] Surfactant is not produced in adequate amounts until relatively late in gestation (34 to 36 weeks); thus, risk of respiratory distress syndrome (RDS) increases with greater prematurity. Other risk factors include multifetal pregnancies, maternal diabetes, and being a White male. […] Rare cases are hereditary, caused by mutations in surfactant protein (SP-B and SP-C) and ATP-binding cassette transporter A3 (ABCA3) genes.

• #2 Neonatal respiratory distress syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001563.htm

  Neonatal respiratory distress syndrome (RDS) is a problem often seen in premature babies. The condition makes it hard for the baby to breathe. […] Neonatal RDS occurs in infants whose lungs have not yet fully developed. […] The disease is mainly caused by a lack of a slippery substance in the lungs called surfactant. This substance helps the lungs fill with air and keeps the air sacs from deflating. Surfactant is present when the lungs are fully developed. […] Neonatal RDS can also be due to genetic problems with lung development. […] Most cases of RDS occur in babies born before 37 to 39 weeks. The more premature the baby is, the higher the chance of RDS after birth. The problem is uncommon in babies born full-term or later (39 weeks or after). […] Other factors that can increase the risk for RDS include: A brother or sister who had RDS, Diabetes in the mother, Cesarean delivery or induction of labor before the baby is full-term, Problems with delivery that reduce blood flow to the baby, Multiple pregnancy (twins or more), Rapid labor.

• #2 Risk factors for respiratory distress syndrome in full-term neonates

  https://www.e-jyms.org/journal/view.php?doi=10.12701/yujm.2018.35.2.187

  Respiratory distress syndrome (RDS) is a one of the most common cause of respiratory morbidity and mortality in neonates. This study was conducted to investigate the risk factors for RDS in full-term neonates. […] The risk factors for RDS in full-term neonates were identified as male sex, cesarean section, and multiparity. Further studies involving more institutions are needed to clarify the risk factors for RDS in full-term infants. […] Neonatal respiratory distress syndrome (RDS) is one of the major causes of respiratory failure and neonatal death in premature infants and is caused by a lack of pulmonary surfactant due to fetal lung immaturity. […] In this study, it was found that male sex, cesarean section, and multiparity had a statistically significant association with an increased incidence of RDS.

• #2

  https://step1.medbullets.com/respiratory/117030/neonatal-respiratory-distress-syndrome

  CXRPathophysiology […] immature fetal lungs have a deficiency in surfactant […] reduced surfactant results in low lung compliance and subsequent atelectasis, intrapulmonary shunting, and acute lung injury […] Causes […] prematurity (most important) […] type II pneumocytes not developed […] normal source of surfactant production […] Cesarean section […] lack of vaginal compression stress on the infant during delivery results in reduced fetal cortisol production and resultant reduction in surfactant production […] maternal diabetes […] high insulin levels decrease surfactant production […] increased fetal blood glucose results in increased fetal insulin production.

• #2 A Parental Guide to Neonatal Respiratory Distress Syndrome (RDS)

  https://womenandchildren.avisena.com.my/health-articles/breathing-easy-navigating-neonatal-respiratory-distress-syndrome-rds/

  Elective caesarean deliveries before labour can increase the risk of RDS in babies, as labour helps in preparing the lungs by promoting surfactant production and clearing fluid. […] Multiples such as twins or triplets are more likely to be born prematurely and at risk for respiratory distress syndrome. Uneven lung maturity can occur due to shared resources in the womb. […] Certain conditions such as perinatal asphyxia and cold stress can lead to delayed production or function of surfactant in full-term babies, causing respiratory difficulties. […] When preterm birth is anticipated, administering corticosteroids to the mother can significantly accelerate foetal lung maturation. Failure to receive this treatment increases the likelihood of RDS. […] Male infants, particularly premature ones, are more prone to RDS than females. This disparity may be linked to slower lung development in male foetuses.

• #2 Respiratory distress syndrome (RDS) in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/respiratory-distress-syndrome-rds-in-neonates

  Respiratory distress syndrome (RDS) is when the neonate has difficulty breathing due to surfactant deficiency at birth. RDS, also known as hyaline membrane disease (HMD), is the dominant clinical problem faced by preterm infants and is directly related to structurally immature and surfactant deficient lungs. […] The greatest risk factor is low gestational age and the development of the disease begins with the impaired synthesis of pulmonary surfactant associated with prematurity. […] The disease is exacerbated by treatable and preventable factors including: cold stress, hypoxia, acidosis, secondary surfactant deficiencies – meconium aspiration syndrome, infant of diabetic mother, pneumonia.

• #2 Risk factors for respiratory distress syndrome in full-term neonates

  https://www.e-jyms.org/journal/view.php?doi=10.12701/yujm.2018.35.2.187

  Cesarean section is known to be an important factor affecting the respiratory difficulties in newborns. […] In this study, it was confirmed that more infants born to multiparous women had RDS, thereby confirming multiparity to be a risk factor for the same. […] Factors, such as birth weight, maternal age at birth, history of abortion, pregnancy-induced hypertension, gestational diabetes, oligohydramnios, premature rupture of membranes, and intrauterine growth restriction were not found to be directly related to the development of RDS in this study.

• #2 Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt | Annals of Global Health

  https://annalsofglobalhealth.org/articles/10.5334/aogh.2739

  The underlying causes of neonatal respiratory distress are diverse and does not always lie within the lungs. […] The most common maternal factors for occurrence of respiratory diseases were PROM (22%), antepartum hemorrhage (20.6%), maternal diabetes (17.24%) and oligohydraminos (13.8%). […] The current study found that multiple gestation pregnancies was associated with high risk of neonatal respiratory diseases (26.2%). […] The results of our study demonstrated that PROM was also an important risk factor for neonatal RDS.

• #2 Neonatal Respiratory Distress Syndrome

  https://www.healthline.com/health/neonatal-respiratory-distress-syndrome

  Neonatal respiratory distress syndrome, or neonatal RDS, may occur if the lungs arent fully developed. It typically occurs in premature babies. Infants with neonatal RDS have difficulty breathing normally. […] Surfactant is a substance that enables the lungs to expand and contract. It also keeps the small air sacs in the lungs, known as alveoli, open. Premature infants lack surfactant. This can cause lung problems and trouble breathing. […] RDS may also occur because of a developmental problem linked to genetics.

• #2 Respiratory Distress Syndrome in the Neonate | Obgyn Key

  https://obgynkey.com/respiratory-distress-syndrome-in-the-neonate/

  Mutations in genes encoding surfactant protein-B (SP-B), surfactant protein-C (SP-C), the ATP binding cassette subfamily A, member 3 (ABCA3), and the thyroid transcription factor (NKX2-1) represent rare monogenic causes of RDS. […] The absence of SP-B, the presence of an incompletely processed proSP-C, and a generalized disruption of surfactant metabolism cause surfactant dysfunction and the clinical syndrome. […] Dominant mutations in the SP-C gene are present in significantly less than 0.1% of the population and typically result in interstitial lung disease in infants older than 1 month of age, although an RDS-like presentation has been described. […] Recessive, deleterious mutations in ABCA3 are present in approximately 4% of the population and have been identified in association with lethal RDS in newborns and with chronic respiratory insufficiency in children.

• #2 Unusual Cause of Respiratory Distress in a Term Neonate | Ochsner Journal

  https://www.ochsnerjournal.org/content/22/2/196

  Genetic variants of NKX2.1 have been associated with decreased surfactant production contributing to neonatal respiratory distress syndrome and the development of interstitial lung disease. […] The finding of ground glass opacities on chest CT scan in our patient and his continued respiratory distress may be explained by NKX2.1 gene dysfunction and correlated to decreased surfactant production resulting from altered protein metabolism. […] Despite its rarity, clinicians should have a high index of suspicion for pulmonary disease caused by surfactant protein mutations when evaluating a child with unexplained respiratory symptoms. NKX2.1 is a genetic defect that can potentially cause interstitial lung disease and should be suspected in neonates with hypothyroidism or neurologic abnormalities; however, respiratory distress secondary to this mutation can present even without hypothyroidism or neurologic abnormalities.

• #2 Genetic Disorders of Neonatal Respiratory Function | Pediatric Research

  https://www.nature.com/articles/pr2001159

  Genetic risk for respiratory distress in infancy has been recognized with increasing frequency in neonatal intensive care units. […] Reports of family clusters of affected infants and of ethnic- and gender-based respiratory phenotypes point to the contribution of inheritance. […] Similarly, different outcomes among gestationally matched infants with comparable exposures to oxygen, mechanical ventilation, or nutritional deficiency also suggest a genetic risk for respiratory distress. […] Examples of inherited deficiency of surfactant protein B in both humans and genetically engineered murine lineages illustrate the importance of identifying markers of genetic risk. […] In contrast to developmental, inflammatory, or nutritional causes of respiratory distress that may resolve as infants mature, genetic causes result in both acute and chronic (and potentially irreversible) respiratory failure.

• #2 Understanding Neonatal Respiratory Distress Syndrome (NRDS): Caus

  https://www.openaccessjournals.com/articles/understanding-neonatal-respiratory-distress-syndrome-nrds-causes-symptoms-and-management-17567.html

  NRDS primarily arises due to insufficient surfactant production in the immature lungs of preterm infants. […] The production of surfactant begins in the late stages of fetal lung development, with significant synthesis occurring during the third trimester of pregnancy. […] Additionally, maternal factors such as diabetes, maternal hypertension, and maternal infections can further exacerbate surfactant deficiency in the newborn. […] Other risk factors for NRDS include perinatal asphyxia, meconium aspiration syndrome, and cesarean section delivery without labor, which may result in inadequate lung expansion and surfactant release. […] Male gender, multiple gestation pregnancies, and maternal ethnicity have also been associated with an increased risk of NRDS.

• #2 Infant Respiratory Distress Syndrome (IRDS)

  https://patient.info/doctor/infant-respiratory-distress-syndrome

  Infant respiratory distress syndrome (IRDS) is caused by the inadequate production of surfactant in the lungs. Surfactant is normally produced by type II pneumocytes and has the property of lowering surface tension. […] Inadequate surfactant production causes air sacs to collapse on expiration and greatly increases the energy required for breathing. […] Secondary surfactant deficiency may occur in infants as a result of: Intrapartum asphyxia. […] The incidence of IRDS decreases with: The use of antenatal steroids. […] The incidence and severity are related inversely to the gestational age of the infant; a 2012 study showed 98% of babies born at 24 weeks had IRDS, while at 34 weeks, the incidence was 5%, and at 37 weeks was less than 1%. […] Antenatal corticosteroids (dexamethasone) accelerate fetal surfactant production and lung maturation. They have been shown to reduce infant respiratory distress syndrome, intraventricular haemorrhage and mortality by 40%.

• #2 Neonatal Respiratory Distress Syndrome (RDS) Imaging: Practice Essentials, Radiography, Ultrasonography

  https://emedicine.medscape.com/article/409409-overview

  Respiratory distress syndrome (RDS) of the newborn is an acute lung disease caused by surfactant deficiency, which leads to alveolar collapse and noncompliant lungs. […] The incidence and severity of RDS are inversely related to gestational age. RDS is the most common cause of respiratory failure during the first days after birth. In addition to prematurity, other factors contributing to the development of RDS are maternal diabetes, cesarean delivery without preceding labor, being the second born of twins, perinatal asphyxia, perinatal infection, and patent ductus arteriosus. […] Lahra et al found that maternal and fetal intrauterine inflammatory responses (chorioamnionitis and umbilical vasculitis) are protective for RDS. In this study, chorioamnionitis with umbilical vasculitis was found to provide a markedly greater reduction of RDS than the presence of chorioamnionitis alone.

• #2 What is Neonatal Respiratory Distress Syndrome?

  https://www.icliniq.com/articles/newborn-and-baby/neonatal-respiratory-distress-syndrome

  Neonatal respiratory distress syndrome (RDS) is a serious medical condition that affects premature infants, particularly those born before 37 weeks of gestation. RDS is characterized by breathing difficulties caused by the underdevelopment of lungs, which lack sufficient surfactant – a substance that helps to keep the air sacs in the lungs from collapsing. […] The causes of neonatal respiratory distress syndrome (RDS) are: Lack of sufficient surfactant in the lungs of premature infants. […] Premature birth before 37 weeks of gestation. […] Maternal diabetes. […] Fetal distress during delivery. […] Genetic predisposition. […] Multiple pregnancies (twins, triplets). […] Male gender. […] C-section delivery without labor. […] Low birth weight. […] Prolonged rupture of membranes (more than 24 hours). […] Maternal drug use (for example, corticosteroids and beta-blockers). […] Maternal smoking during pregnancy.

• #2 Neonatal respiratory distress – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/neonatal-respiratory-distress/

  Respiratory distress is common; it affects 7% of term infants. It is the most common reason term babies are admitted to special and intensive care nurseries. Several factors increase the likelihood of respiratory distress occurring in a term neonate: meconium exposure, maternal gestational diabetes, chorioamnionitis, oligohydramnios and delivery by caesarian section. […] The aetiology of respiratory distress is as varied as the causes. Many infants struggle with the transition from birth to neonatal life. Whatever the underlying pathology, surfactant deficiency, meconium aspiration or persistent pulmonary hypertension, these cause atelectasis and ventilation-perfusion (V/Q) mismatch. Leading to hypoxemia and hypercarbia, and, ultimately, respiratory acidosis. Tissues then become poorly perfused, leading to metabolic acidosis, which furthers pulmonary vasoconstriction, causing endothelial and epithelial injury and respiratory distress syndrome.

• #2 Neonatal respiratory distress syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/neonatal-respiratory-distress-syndrome/

  Neonatal respiratory distress syndrome is caused by impaired synthesis and secretion of surfactant. Risk factors include: […] Maternal diabetes mellitus: leads to fetal insulin, which inhibits surfactant synthesis. […] Cesarean delivery: results in lower levels of fetal glucocorticoids than vaginal delivery, in which higher levels are released as a response to stress from uterine contractions. […] Surfactant deficiency is most likely to occur in preterm infants, because: Surfactant production begins at approximately 20 weeks gestation. […] The lower the lecithin-sphingomyelin ratio, the more likely it is that the lungs are immature. […] Deficiency of pulmonary surfactant. […] Immature respiratory control. […] Elevated pulmonary vascular resistance right-to-left shunting through the foramen ovale and patent ductus arteriosus (bypassing the lungs) pre- and postductal oxygenation gradient (e.g., preductal O2 saturation is often higher than postductal). […] Associated with abnormal prenatal development of or perinatal maladaptation of pulmonary vasculature.

• #2 Respiratory Distress Syndrome (RDS) in Premature Babies – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=respiratory-distress-syndrome-rds-in-premature-babies-90-P02371

  Respiratory distress syndrome (RDS) is a common problem in premature babies. […] RDS occurs when there is not enough surfactant in the lungs. […] An unborn baby starts to make surfactant at about 26 weeks of pregnancy. […] If a baby is premature (born before 37 weeks of pregnancy), he or she may not have made enough surfactant yet. […] The more premature the baby, the higher the risk and the more severe the RDS. […] The baby has a condition called patent ductus arteriosus (PDA). […] Preventing a premature birth is the main way to prevent RDS.

• #2 Respiratory Distress Syndrome in Newborn

  https://www.picmonic.com/pathways/nursing/courses/standard/medical-surgical-nursing-pathophysiology-296/respiratory-disorders-2154/neonatal-respiratory-distress-syndrome_2265

  Neonatal respiratory distress syndrome (NRDS) is a condition related to fetal lung immaturity in premature infants (37 weeks gestational age) and a lack of surfactant. […] Fetal lung immaturity may lead to the development of neonatal respiratory distress syndrome (NRDS). Premature infants born less than 37 weeks gestational age are at an increased risk of developing NRDS. […] Other causes of NRDS not related to prematurity or of pulmonary origin include sepsis, heart defects, exposure to cold, obstruction of the airway, intraventricular hemorrhage, hypoglycemia, metabolic acidosis, blood loss, and drugs. […] Neonatal respiratory distress syndrome is most commonly caused by a lack of surfactant in the infant’s lungs. Surfactant is a substance that reduces surface tension in the alveoli of the lungs and helps to prevent alveolar collapse. The more premature the newborn, the less surfactant available, thus increasing the likelihood of NRDS.

• #2 The Underlying Causes of Respiratory Distress in Late-Preterm and Full-Term Infants Are Different From Those of Early-Preterm Infants

  https://brieflands.com/articles/ijp-104011

  The current results showed that the perinatal risk factors associated with severe RDS varied among infants of different GAs; the severity of RDS in EP infants may be associated with a lower GA, immature lung development, and lack of surfactant secretion. By contrast, the severity of RDS in LP/FT infants is more likely related to perinatal infection, hypoxia, and cesarean delivery. […] These findings were consistent with the results of our previous single-centre study and with data in the literature, supporting the finding that the pathogenic mechanism of RD in LP and FT infants differs from that in EP infants.

• #2 Risk factors for respiratory distress syndrome in full-term neonates

  https://www.e-jyms.org/journal/view.php?number=2409

  Cesarean section is known to be an important factor affecting the respiratory difficulties in newborns. […] In this study, it was confirmed that more infants born to multiparous women had RDS, thereby confirming multiparity to be a risk factor for the same. […] Factors, such as birth weight, maternal age at birth, history of abortion, pregnancy-induced hypertension, gestational diabetes, oligohydramnios, premature rupture of membranes, and intrauterine growth restriction were not found to be directly related to the development of RDS in this study. […] In conclusion, the risk factors for RDS in full-term infants were male sex, cesarean section, and multiparity. However, prospective studies involving more hospitals are needed.

• #2 Genetic Disorders of Neonatal Respiratory Function | Pediatric Research

  https://www.nature.com/articles/pr2001159

  These family studies suggested that a single-gene, loss-of-function mutation results in irreversible respiratory distress syndrome in infancy. […] Genetic and biochemical studies of compound heterozygote infants, heterozygote adults, and mice heterozygous for targeted disruption of the surfactant protein B gene suggest that approximately 50% of normal surfactant protein B synthesis may be sufficient for normal pulmonary function at birth. […] These observations suggest that acute and chronic respiratory distress syndrome may result from genetic variation in the human surfactant protein B gene. […] Identification of infants with loss-of-function mutations in this gene permits reliable prediction of development of acute or chronic respiratory distress. […] Additional population-based analyses of genotype-phenotype correlation, including both respiratory distress in the neonatal period and long-term respiratory morbidity, are required to quantify the contribution of mutations in surfactant protein genes and extrapulmonary genes to the frequency of respiratory distress syndrome and subsequent pulmonary disease.

• #2 Causes and treatment of neonatal respiratory distress syndrome | Nursing Times

  https://www.nursingtimes.net/respiratory/causes-and-treatment-of-neonatal-respiratory-distress-syndrome-27-07-2004/

  RDS is caused by defective or delayed production of surfactant in structurally immature lungs. […] Perinatal asphyxia, maternal diabetes, and caesarean section are other important factors in the aetiology of surfactant-deficient RDS. […] The most common sequela of RDS is chronic lung disease or bronchopulmonary dysplasia.

• #2 Respiratory Distress Syndrome of the Newborn | RT

  https://respiratory-therapy.com/public-health/pediatrics/neonatal/respiratory-distress-syndrome-of-the-newborn/

  Respiratory distress syndrome of the newborn (RDS) occurs in premature infants secondary to insufficient surfactant production and structural immaturity of the infants lungs. […] Other etiologies include neonatal infection, often a gram-negative bacteremia and genetic lack of normal surfactant protein production. […] Regardless of the cause of RDS, if not recognized and managed quickly, respiratory distress can escalate to respiratory failure and cardiopulmonary arrest. […] The two major management approaches to prevent the development of RDS are the use of antenatal treatment of women in preterm labor with glucocorticoid hormone to accelerate fetal lung maturation and the early use of surfactant replacement therapy. […] Prophylactic or preventive surfactant administration is defined as endotracheal intubation and surfactant administration to infants at high risk of developing RDS. […] Together with antenatal corticosteroid treatment, the use of prophylactic surfactant has made the greatest contribution to decreasing the incidence of RDS and its associated mortality and morbidity.

• #2 HIE Multimedia – Neonatal respiratory distress syndrome

  https://adamcertificationdemo.adam.com/content.aspx?productid=117&pid=1&gid=001563

  Taking steps to prevent premature birth can help prevent neonatal RDS. Good prenatal care and regular checkups beginning as soon as a woman discovers she is pregnant can help avoid premature birth. […] The risk of RDS can also be lessened by the proper timing of delivery. An induced delivery or cesarean may be needed. […] Medicines called corticosteroids can help speed up lung development before a baby is born.

• #2 Respiratory Distress Syndrome in the Neonate | Obgyn Key

  https://obgynkey.com/respiratory-distress-syndrome-in-the-neonate/

  Enormous strides have been made in understanding the pathophysiology of respiratory distress syndrome (RDS) and the role of surfactant in its cause and treatment. […] RDS, formerly referred to as hyaline membrane disease, remains a dominant clinical problem encountered among preterm infants. […] The greatly improved outcome in RDS can be attributed primarily to the introduction of pharmacologic acceleration of pulmonary maturity and the development of surfactant replacement therapy. […] The greatest risk factors appear to be young gestational age and low birth weight; however, European descent, late preterm delivery (35 to 36 weeks), or elective delivery in the absence of labor are also prominent risk factors. […] Given the associated adverse respiratory outcomes of late preterm and early term births, initiatives to delay elective deliveries until 39 weeks gestation have been successful in reducing pulmonary and nonpulmonary morbidity in these infants.

• #2 Respiratory Distress Syndrome (RDS) | Birth Injury Lawyers

  https://www.nationalbirthinjurylaw.com/respiratory-distress-syndrome

  Failure to quickly initiate such treatment is often considered medical malpractice if the delay results in an unnecessary birth injury such as HIE or cerebral palsy. […] Prevention of neonatal respiratory distress syndrome largely boils down to prevention of preterm birth and administration of proper treatment when preterm birth is unavoidable. […] In absence of corticosteroid therapy during pregnancy, prophylactic surfactant therapy may be administered to the premature baby who is at a high risk of developing respiratory distress syndrome. […] Studies have shown that surfactant therapy given through the trachea (intratracheal) may reduce the risk of severe lung complications and neonatal death.

• #3 Respiratory Distress in the Newborn | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/1001/p987.html

  The most common etiology of neonatal respiratory distress is transient tachypnea of the newborn; this is triggered by excessive lung fluid, and symptoms usually resolve spontaneously. […] Respiratory distress syndrome can occur in premature infants as a result of surfactant deficiency and underdeveloped lung anatomy. […] Meconium aspiration syndrome is thought to occur in utero as a result of fetal distress by hypoxia. […] Other etiologies of respiratory distress include pneumonia, sepsis, pneumothorax, persistent pulmonary hypertension, and congenital malformations; treatment is disease specific. […] Respiratory distress syndrome of the newborn, also called hyaline membrane disease, is the most common cause of respiratory distress in premature infants, correlating with structural and functional lung immaturity.

• #3 Respiratory Distress Syndrome (RDS) in Premature Babies – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=respiratory-distress-syndrome-rds-in-premature-babies-90-P02371

  Respiratory distress syndrome (RDS) is a common problem in premature babies. […] RDS occurs when there is not enough surfactant in the lungs. […] An unborn baby starts to make surfactant at about 26 weeks of pregnancy. […] If a baby is premature (born before 37 weeks of pregnancy), he or she may not have made enough surfactant yet. […] The more premature the baby, the higher the risk and the more severe the RDS. […] The baby has a condition called patent ductus arteriosus (PDA). […] Preventing a premature birth is the main way to prevent RDS.

• #3 A Parental Guide to Neonatal Respiratory Distress Syndrome (RDS)

  https://womenandchildren.avisena.com.my/health-articles/breathing-easy-navigating-neonatal-respiratory-distress-syndrome-rds/

  Elective caesarean deliveries before labour can increase the risk of RDS in babies, as labour helps in preparing the lungs by promoting surfactant production and clearing fluid. […] Multiples such as twins or triplets are more likely to be born prematurely and at risk for respiratory distress syndrome. Uneven lung maturity can occur due to shared resources in the womb. […] Certain conditions such as perinatal asphyxia and cold stress can lead to delayed production or function of surfactant in full-term babies, causing respiratory difficulties. […] When preterm birth is anticipated, administering corticosteroids to the mother can significantly accelerate foetal lung maturation. Failure to receive this treatment increases the likelihood of RDS. […] Male infants, particularly premature ones, are more prone to RDS than females. This disparity may be linked to slower lung development in male foetuses.

• #3 Neonatal respiratory distress syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/neonatal-respiratory-distress-syndrome/

  Neonatal respiratory distress syndrome is caused by impaired synthesis and secretion of surfactant. Risk factors include: […] Maternal diabetes mellitus: leads to fetal insulin, which inhibits surfactant synthesis. […] Cesarean delivery: results in lower levels of fetal glucocorticoids than vaginal delivery, in which higher levels are released as a response to stress from uterine contractions. […] Surfactant deficiency is most likely to occur in preterm infants, because: Surfactant production begins at approximately 20 weeks gestation. […] The lower the lecithin-sphingomyelin ratio, the more likely it is that the lungs are immature. […] Deficiency of pulmonary surfactant. […] Immature respiratory control. […] Elevated pulmonary vascular resistance right-to-left shunting through the foramen ovale and patent ductus arteriosus (bypassing the lungs) pre- and postductal oxygenation gradient (e.g., preductal O2 saturation is often higher than postductal). […] Associated with abnormal prenatal development of or perinatal maladaptation of pulmonary vasculature.

• #3 Risk factors for respiratory distress syndrome in full-term neonates

  https://www.e-jyms.org/journal/view.php?doi=10.12701/yujm.2018.35.2.187

  Respiratory distress syndrome (RDS) is a one of the most common cause of respiratory morbidity and mortality in neonates. This study was conducted to investigate the risk factors for RDS in full-term neonates. […] The risk factors for RDS in full-term neonates were identified as male sex, cesarean section, and multiparity. Further studies involving more institutions are needed to clarify the risk factors for RDS in full-term infants. […] Neonatal respiratory distress syndrome (RDS) is one of the major causes of respiratory failure and neonatal death in premature infants and is caused by a lack of pulmonary surfactant due to fetal lung immaturity. […] In this study, it was found that male sex, cesarean section, and multiparity had a statistically significant association with an increased incidence of RDS.

• #3 Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt | Annals of Global Health

  https://annalsofglobalhealth.org/articles/10.5334/aogh.2739

  Respiratory diseases in newborns are considered major causes of neonatal morbidity and mortality especially in developing countries. Its causes are diverse and require early detection and management. […] The most common detected respiratory diseases were respiratory distress syndrome (RDS; 49.6%), transient tachypnea of newborn (TTN; 22%), neonatal pneumonia (17.2%) and meconium aspiration syndrome (MAS; 6.21%). Premature rupture of membrane (PROM), maternal diabetes and fetal prematurity had the highest risk factors for respiratory diseases occurrence in neonates. […] Respiratory distress syndrome carried the highest risk of mortality and TTN carried the highest survival rate. […] Certain risk factors increase the susceptibility for neonatal respiratory diseases as prematurity, meconium aspiration, caesarian section delivery, gestational diabetes, maternal chorioamnionitis, and prenatal ultrasonographic findings, such as oligohydramnios and structural lung disorders.

• #3 Unusual Cause of Respiratory Distress in a Term Neonate | Ochsner Journal

  https://www.ochsnerjournal.org/content/22/2/196

  Respiratory distress is a clinical finding often seen in neonates. Common causes of respiratory distress in this population include respiratory distress syndrome, transient tachypnea of the newborn, infection, aspiration, and cardiac etiologies. […] The patient was eventually found to have a variant of a genetic mutation that predisposed the infant to this presentation. […] The patient was eventually found to have a genetic mutation causing surfactant dysfunction, predisposing the infant to this presentation. […] Most of the common underlying etiologies for respiratory distress were ruled out. In view of the patient’s clinical presentation and CT scan, interstitial lung disease was suspected. Genetic studies for surfactant protein mutations were obtained before the patient was transferred. The genetic evaluation was positive for NKX2.1 variance mutation C.190C.

• #3 Genetic Testing for Neonatal Respiratory Disease

  https://www.mdpi.com/2227-9067/8/3/216

  Genetic mechanisms are now recognized as rare causes of neonatal lung disease. […] The most common neonatal lung disease associated with prematurity is respiratory distress syndrome (RDS), caused by deficient production of pulmonary surfactant owing to lung immaturity. […] Genetic mechanisms disrupting surfactant metabolism can result in diffuse lung disease in near-term and full-term infants that mimics RDS in prematurely born infants. […] Pulmonary hypertension and abnormalities of lung development may also arise from genetic mechanisms. […] Genetic mechanisms disrupting or altering the production of SP-B and SP-C might result in lung disease. […] Sequence variations in SFTPC also cause diffuse lung disease, but in contrast to the loss-of-function sequence variants in SFTPB, the sequence variations in SFTPC lead to production of an abnormal form of proSP-C.

• #3 Genetic Testing for Neonatal Respiratory Disease

  https://www.mdpi.com/2227-9067/8/3/216

  Sequence variants in the gene (ABCA3) disrupting or limiting production of ABCA3 may therefore cause surfactant deficiency. […] The principal cause of ACD-MPV results from deletions or sequence variants in one allele of the gene encoding the transcription factor, FOXF1. […] Genetic disorders disrupting surfactant function, metabolism, or lung development cause lung disease that is usually progressive. […] Genetic testing is warranted in all neonates with respiratory distress persisting for >48 h that is not adequately explained by history and other laboratory findings yielding a specific diagnosis.

• #3 Respiratory Distress Syndrome in the Neonate | Obgyn Key

  https://obgynkey.com/respiratory-distress-syndrome-in-the-neonate/

  Mutations in genes encoding surfactant protein-B (SP-B), surfactant protein-C (SP-C), the ATP binding cassette subfamily A, member 3 (ABCA3), and the thyroid transcription factor (NKX2-1) represent rare monogenic causes of RDS. […] The absence of SP-B, the presence of an incompletely processed proSP-C, and a generalized disruption of surfactant metabolism cause surfactant dysfunction and the clinical syndrome. […] Dominant mutations in the SP-C gene are present in significantly less than 0.1% of the population and typically result in interstitial lung disease in infants older than 1 month of age, although an RDS-like presentation has been described. […] Recessive, deleterious mutations in ABCA3 are present in approximately 4% of the population and have been identified in association with lethal RDS in newborns and with chronic respiratory insufficiency in children.

• #3 Genetic Disorders of Neonatal Respiratory Function | Pediatric Research

  https://www.nature.com/articles/pr2001159

  Genetic risk for respiratory distress in infancy has also been suggested by reports of family clusters of affected infants, by studies of different ethnic groups and sex, by characterization of infants with inherited deficiency of surfactant protein B, and by targeted gene ablation in murine lineages. […] In contrast to nongenetic causes of respiratory distress that may resolve as infants mature, genetic causes result in both acute and chronic (and potentially irreversible) respiratory failure. […] Genetic variation in human surfactant protein genes A, B, and C, and in other extrapulmonary genes (granulocyte-macrophage colony-stimulating factor and its receptor) has provided the first examples of such genetic tools. […] Surfactant protein B deficiency was the first reported genetic cause of lethal respiratory distress syndrome in infants.

• #3 HIE Multimedia – Neonatal respiratory distress syndrome

  https://adamcertificationdemo.adam.com/content.aspx?productid=117&pid=1&gid=001563

  Taking steps to prevent premature birth can help prevent neonatal RDS. Good prenatal care and regular checkups beginning as soon as a woman discovers she is pregnant can help avoid premature birth. […] The risk of RDS can also be lessened by the proper timing of delivery. An induced delivery or cesarean may be needed. […] Medicines called corticosteroids can help speed up lung development before a baby is born.

• #3

  https://www.ijpediatrics.com/index.php/ijcp/article/view/2897

  Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and neonatal death. […] This study aims at studying the risk factors for developing RDS in term neonates. […] In our study RDS in term neonates was significantly associated with following risk factors like selective cesarean section, male sex, SGA, oligohydramnios, MSAF, severe fetal distress, birth asphyxia, PROM, and maternal-fetal infection. […] Several high-risk factors such as severe birth asphyxia, maternal-fetal infection, PROM, and MSAF were closely correlated with full-term neonatal RDS.

• #3 RESPIRATORY DISTRESS IN INFANTS AND ADULTS – Brave Beginnings

  https://bravebeginnings.org/respiratory-distress-in-infants-and-adults/

  Respiratory Distress Syndrome (RDS) is a serious condition that most often afflicts premature infants, although other babies can also have the condition. Babies develop RDS when their lungs do not produce enough surfactant, a liquid produced by the lungs that keeps the airways, or alveoli, open, allowing the infants to breathe. The fetus begins to produce surfactant at around 26 weeks, so babies born before 28 weeks are particularly susceptible to RDS. […] Since prematurity is the main cause of RDS, reducing the number of early births is the best prevention. However, in some instances, doctors can give women who are experiencing premature birth or who are at risk of it a corticosteroid injection to hasten the development of the baby’s lungs.

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