What is the primary cause of Respiratory Distress Syndrome in neonates?

The primary cause of Respiratory Distress Syndrome (RDS) in neonates is surfactant deficiency. In healthy lungs, surfactant, a substance composed primarily of lipids and proteins, plays a critical role in reducing surface tension within the alveoli, preventing their collapse during expiration. This is especially important in newborns, particularly those born prematurely, as their lungs may not have matured enough to produce adequate amounts of surfactant.

Without sufficient surfactant, the alveoli can collapse, leading to atelectasis, impaired gas exchange, and respiratory distress. This condition is more prevalent in preterm infants because surfactant production typically increases significantly as the fetus nears term, usually around 34 to 36 weeks of gestation. Therefore, neonates, especially those who are preterm, may experience severe difficulty in breathing and maintaining adequate oxygenation due to this deficiency. Understanding surfactant's essential function helps clarify why its absence is a central focus in neonatal respiratory pathologies.