Respiratory Distress Syndrome

Respiratory distress syndrome is a newborn breathing condition caused by a lack of surfactant in the lungs.

Overview

Respiratory distress syndrome is a common breathing disorder that affects newborns. Respiratory distress syndrome occurs most often in babies born before their due date, usually before 28 weeks of pregnancy. Less often, respiratory distress syndrome can affect full-term newborns.

Most newborns who have respiratory distress syndrome survive. However, these babies may need extra medical care after going home. Some babies have complications from respiratory distress syndrome or its treatment, including the development of another lung condition called bronchopulmonary dysplasia.

Related Terms: 

  • Neonatal respiratory distress syndrome (RDS)
  • ARDS (Acute Respiratory Distress Syndrome)
  • Transient tachypnea of the newborn (TTN)
  • Bronchopulmonary dysplasia (BPD)
  • Meconium aspiration syndrome
  • Persistent pulmonary hypertension of the newborn

Signs and Symptoms

Symptoms of respiratory distress syndrome in newborns include:

  • Fast and shallow breathing
  • Grunting
  • Flaring of the nostrils with each breath
  • Bluish tone to a baby’s skin and lips
  • Pulling inward of the muscles between the ribs when breathing

Respiratory distress syndrome may develop over time into a more serious and persistent condition called bronchopulmonary dysplasia (BPD) that requires oxygen, a ventilator, or medicines to help with breathing. If a baby born with respiratory distress syndrome still requires breathing support by the time they reach their original due date, they are diagnosed with bronchopulmonary dysplasia.

Depending on how serious their respiratory distress syndrome is, babies may also develop other medical conditions, including:

Causes and Risk Factors

Respiratory distress syndrome is caused by a lack of surfactant in the lungs. The lungs of a fetus start making surfactant during the third trimester, which starts after the 26th week of pregnancy. Without surfactant, the lungs collapse, and the newborn must work hard to breathe. Respiratory distress syndrome affects most babies who are born before 32 weeks of pregnancy. Premature birth, especially before 32 weeks of pregnancy, commonly leads to respiratory distress syndrome in newborns. Nearly all babies born before 28 weeks of pregnancy will have respiratory distress syndrome.

If a full-term baby develops respiratory distress syndrome, it may be because they have faulty genes that affect how their bodies make surfactant.

Prevention Guidance

If your healthcare provider is concerned that you may give birth several weeks before your due date, they may give you medicines called corticosteroids to help decrease the risk of breathing disorders for your newborn.

Diagnosis

Respiratory distress syndrome is common in premature newborns, but doctors may need to run tests to rule out other types of newborn breathing conditions. After doing a physical examination to look at a newborn’s symptoms, your provider may order one or more of the following tests:

  • Lung imaging tests such as chest X-rays show how well the lungs and heart are working. X-rays are used to diagnose most types of newborn breathing conditions.
  • Heart tests such as an echocardiogram can check for a possible congenital heart defect.
  • Blood tests look for an infection.

Treatment and Management

With treatment, many newborns that are diagnosed with respiratory distress syndrome will recover. Often, newborn breathing conditions can be treated if they are found early. Most babies improve gradually in the days, weeks, and months that follow, when they get the right treatment and supervision.

Some common treatments for newborn respiratory distress syndrome include:

  • Nasal continuous positive airway pressure (nCPAP): This device provides breathing support by gently pushing air into the baby’s lungs through prongs placed in the nose.
  • Surfactant replacement therapy: This can be used if a newborn struggles to breathe despite the use of nCPAP. Sometimes, giving an infant surfactant requires the use of a breathing tube. If so, because of the possible complications, your baby’s provider will help you consider the risks and benefits of the procedure.
  • Mechanical ventilation: This is used only in very serious cases of respiratory distress syndrome. A ventilator is a machine that takes over the work of breathing and is a form of life support. The machine connects to a breathing tube that runs through a newborn’s mouth or nose and into the windpipe. Babies that require ventilation are more likely to develop bronchopulmonary dysplasia. They may also develop health problems from the breathing tube or ventilator, such as an airway or lung injury.
  • Fluids and nutrients: These may be given to help prevent malnutrition and promote growth. Nutrition is critical to the growth and development of the lungs.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on respiratory distress syndrome.

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.

NIH also conducts ongoing research on newborn breathing conditions.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.