Which statement best describes the cause of respiratory distress syndrome in preterm infants?

Which statement best describes the cause of respiratory distress syndrome in preterm infants?

• A. It is caused by pulmonary immaturity and surfactant deficiency
• B. It is caused by infection
• C. It is caused by maternal diabetes
• D. It is unrelated to gestational age

Answer: (A)

Pulmonary immaturity with surfactant deficiency is the primary driver of this condition. Surfactant lowers surface tension in the alveoli, keeping them open between breaths. In preterm infants, the lungs are not yet capable of producing enough surfactant, so alveoli collapse easily (atelectasis), lung compliance falls, and gas exchange becomes markedly impaired. This sequence explains the rapid breathing, hypoxemia, and respiratory distress seen soon after birth in very preterm babies. While infections or maternal factors like diabetes can influence risk or severity, the fundamental issue in respiratory distress syndrome of prematurity is insufficient surfactant due to immature lungs. Management focuses on providing exogenous surfactant and supportive respiratory care to improve oxygenation and ventilation.

Pulmonary immaturity with surfactant deficiency is the primary driver of this condition. Surfactant lowers surface tension in the alveoli, keeping them open between breaths. In preterm infants, the lungs are not yet capable of producing enough surfactant, so alveoli collapse easily (atelectasis), lung compliance falls, and gas exchange becomes markedly impaired. This sequence explains the rapid breathing, hypoxemia, and respiratory distress seen soon after birth in very preterm babies. While infections or maternal factors like diabetes can influence risk or severity, the fundamental issue in respiratory distress syndrome of prematurity is insufficient surfactant due to immature lungs. Management focuses on providing exogenous surfactant and supportive respiratory care to improve oxygenation and ventilation.