Neonatal respiratory distress syndrome


Infant Respiratory Distress Syndrome (IRDS) is a respiratory distress syndrome in newborns that occurs acutely in newborns shortly after birth. Premature babies are particularly frequently affected, as the lungs are not matured until the 35th week of pregnancy. In case of an imminent premature birth, therefore, a medical prophylaxis of IRDS is always attempted. Statistically, at least 60% of children born before the 28th week of pregnancy develop a respiratory distress syndrome. Mature children, i.e. those born after the 37th week of pregnancy, are only affected to about 5%.

Cause for the respiratory distress syndrome in the newborn

The main cause of the respiratory distress syndrome is the insufficient production of a certain protein, the surfactant. This protein is located on the surface of the alveoli in all people and ensures that they remain open and do not collapse. The mechanism for this is the reduction of the surface tension, which would otherwise be so great that the fine alveoli are unable to withstand it.

Surfactant is thus the decisive factor for a good and undisturbed gas exchange in our lungs. In newborns and especially in premature infants, surfactant is not yet produced in sufficient quantities, since the lungs are created early in the womb, but do not mature until the very end of the pregnancy. Surfactant is normally only produced by the cells of the infant’s lungs from the 35th week of pregnancy onwards. This means that the alveoli partially collapse in the case of respiratory distress syndrome and the child has to make a disproportionate effort to get enough air.

Respiratory distress syndrome in newborns after caesarean section

After a Caesarean section, the risk for the newborn child to develop a respiratory distress syndrome is generally increased. It does not matter whether the child is premature or mature. The explanation for this is that the stress of childbirth, especially the pressing contractions, cause an acceleration of surfactant production via the release of certain hormones (glucocorticoids). A lack of surfactant is the main reason for the development of a respiratory distress syndrome.

Diagnosis of respiratory distress syndrome in newborns

The first clear indications of a respiratory distress syndrome in a newborn child are first of all the symptoms typical of a respiratory distress and a relatively weak breathing sound when listening to the lungs. In order to confirm the suspected diagnosis, the analysis of the oxygen or carbon dioxide content in the blood (blood gas analysis) and the presentation of the lung in an X-ray image are used. IRDS must be distinguished from other diseases that can also cause respiratory distress, such as underdevelopment of the lungs, pneumonia or amniotic fluid in the lungs.