Respiratory Distress Syndrome, Neonatal
Basics
Description
- Neonatal respiratory distress syndrome (NRDS) is a disorder primarily of prematurity manifested by respiratory distress. However, it can occur in early term neonates as well.
- System(s) affected: respiratory
- Synonym(s): hyaline membrane disease; surfactant deficiency
ALERT
A disorder of the neonatal period
A disorder of the neonatal period
Epidemiology
Incidence
- >90% incidence in infants born ≤28 weeks’ gestation
- 1% all newborns, 10% of preterm infants
- Inversely proportional to gestational age
- Gender: male predominance
- Eighth leading cause of infant death in the United States in 2021: 11.3 infant deaths per 100,000 live births (1)
Etiology and Pathophysiology
- Impaired surfactant synthesis and secretion
- Usually secondary to deficient surfactant (dipalmitoyl lecithin) production in immature lungs
- Leads to low lung compliance, low lung volume, and increased lung resistance
- High oxygen exposure and barotrauma during treatment can cause further damage to alveolar epithelium.
Genetics
No known genetic pattern
Risk Factors
- Premature birth
- Low birth weight
- Infants of diabetic mothers
- Infants of hypertensive mothers
- Perinatal asphyxia
- History of RDS in a sibling
- Cesarean delivery or operative vaginal delivery
- Assisted reproductive technology
- Lack of prenatal care
General Prevention
- Prevention of premature birth:
- Education
- Regular prenatal care
- Management of maternal medical conditions
- Promote healthy behaviors during pregnancy focusing on:
- Diet
- Exercise
- Avoidance of exposure to tobacco smoke, alcohol, and illegal drugs
- Antenatal corticosteroids:
- For babies born between 24 weeks’ and 31 6/7 weeks, gestational age, antenatal corticosteroid use when administered 2 to 7 days prior decreased the risk of NRDS, surfactant use, and death.
- For women at risk for preterm delivery within 24 0/7 and 33 6/7, weeks’ gestation, including those with ruptured membranes and multiple gestations
Commonly Associated Conditions
- Patent ductus arteriosus (PDA)
- Bronchopulmonary dysplasia (BPD)
- Pneumothorax
- Recurrent wheezing, asthma, respiratory infections, and PFT abnormalities
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Citation
Domino, Frank J., et al., editors. "Respiratory Distress Syndrome, Neonatal." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688542/all/Respiratory_Distress_Syndrome_Neonatal.
Respiratory Distress Syndrome, Neonatal. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688542/all/Respiratory_Distress_Syndrome_Neonatal. Accessed December 3, 2024.
Respiratory Distress Syndrome, Neonatal. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688542/all/Respiratory_Distress_Syndrome_Neonatal
Respiratory Distress Syndrome, Neonatal [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 03]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688542/all/Respiratory_Distress_Syndrome_Neonatal.
* Article titles in AMA citation format should be in sentence-case
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T1 - Respiratory Distress Syndrome, Neonatal
ID - 1688542
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688542/all/Respiratory_Distress_Syndrome_Neonatal
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -