Neonatal respiratory distress syndrome is a potentially deadly complication of premature birth. It is characterized by extreme breathing difficulties and blood-oxygen shortages due to poorly developed lungs. Neonatal respiratory distress syndrome is very common in infants who are born before the 28th week of gestation, and the risk lowers considerably for each week thereafter a baby is able to stay in the womb. Modern treatment techniques, including the immediate use of gentle oxygen therapy and lung-strengthening medications, help to reduce the chances of death and major health complications.
Fully developed infant lungs are coated internally with a substance called surfactant that promotes continuous air flow and prevents air spaces from caving in. Babies who are born very prematurely do not have enough surfactant to support normal breathing, and they are highly susceptible to lung collapse. In addition to prematurity, several other factors can contribute to the risk of developing neonatal respiratory distress syndrome. Diabetes in the mother, multiple births, Cesarean section delivery, and family history of newborn complications can all raise the likelihood of having a baby with major lung problems.
Symptoms of neonatal respiratory distress syndrome are usually noticeable a few minutes after delivery. The infant typically has very rapid, shallow breathing and appear to be struggling with each breath. He or she may have a depressed or concave chest and limpness in the extremities. If oxygen levels are very low, there may be a blue tint to the skin and lips as well.
Immediate recognition of symptoms and treatment are essential in preventing fatal complications. Oxygen is supplied either through a continuous positive airway pressure mask or through a breathing tube inserted directly into the throat. Once breathing is somewhat stabilized, blood tests and imaging scans can be performed to determine blood-oxygen levels and the severity of premature lung development. A synthetic form of surfactant may be introduced into the lungs to help them expand and hold their shape.
Most infants with neonatal respiratory distress syndrome need to stay in intensive care units for several weeks under constant monitoring. Other complications related to prematurity can present additional problems, such as poor heart or kidney functioning. Survivors are at risk of developmental disorders related to brain damage, poor vision or eyesight, and failure to physically thrive.
Some cases of neonatal respiratory distress syndrome can be avoided with expert prenatal care. If doctors determine that it is likely a mother will give birth prematurely, they can provide corticosteroids to her developing fetus that promote faster lung development. Careful monitoring in the weeks leading up to the delivery date help physicians determine the likelihood of lung complications so they can be prepared when the baby is born.