What is the most common cause of illness and disease in preterm infants?

What is the most common cause of illness and disease in preterm infants?

• A. Respiratory distress syndrome
• B. Sepsis
• C. Necrotizing enterocolitis
• D. Intraventricular hemorrhage

Answer: (A)

The most common problem in preterm infants is respiratory distress syndrome caused by surfactant deficiency. Surfactant lowers surface tension in the lungs and keeps alveoli open. In babies born early, the lungs aren’t ready to make enough surfactant, so alveoli tend to collapse, lung compliance is very low, ventilation-perfusion matching worsens, and oxygenation becomes difficult. This combination leads to the characteristic breathing difficulties and respiratory failure seen in RDS, making it the frequent first illness in very preterm newborns. While infections like sepsis, brain bleeds such as intraventricular hemorrhage, and intestinal disease like necrotizing enterocolitis are serious and common complications in preterm infants, they typically arise after the initial respiratory problems or in the context of prolonged illness and extreme prematurity. The underlying lack of surfactant is the primary reason RDS stands out as the most common early issue. Management focuses on speeding lung maturation when preterm birth is expected (antenatal steroids), and after birth includes surfactant replacement therapy and supportive ventilation strategies (such as CPAP) to keep the lungs open and improve oxygenation.

The most common problem in preterm infants is respiratory distress syndrome caused by surfactant deficiency. Surfactant lowers surface tension in the lungs and keeps alveoli open. In babies born early, the lungs aren’t ready to make enough surfactant, so alveoli tend to collapse, lung compliance is very low, ventilation-perfusion matching worsens, and oxygenation becomes difficult. This combination leads to the characteristic breathing difficulties and respiratory failure seen in RDS, making it the frequent first illness in very preterm newborns.

While infections like sepsis, brain bleeds such as intraventricular hemorrhage, and intestinal disease like necrotizing enterocolitis are serious and common complications in preterm infants, they typically arise after the initial respiratory problems or in the context of prolonged illness and extreme prematurity. The underlying lack of surfactant is the primary reason RDS stands out as the most common early issue.

Management focuses on speeding lung maturation when preterm birth is expected (antenatal steroids), and after birth includes surfactant replacement therapy and supportive ventilation strategies (such as CPAP) to keep the lungs open and improve oxygenation.