What is neonatal respiratory distress syndrome (NRDS) of newborn?

Verified by Dr. Ashok Gawdi, Consultant Pediatrics & Neonatology, Apollo Children’s, Navi Mumbai.

Neonatal respiratory distress syndrome (NRDS) is a serious lung condition that affects newborn babies. The incidence is higher in extreme premature babies and decreases as gestational age nears full term. It is caused by a lack of surfactant, a substance that helps the lungs expand and contract properly. As a result, babies with NRDS have difficulty breathing and need oxygen and other respiratory support.

Symptoms of respiratory distress syndrome

The symptoms of NRDS usually appear within the first few hours of life. They can include:

• Rapid breathing
• Grunting
• Retractions (pulling in of the chest muscles when breathing)
• Bluish color of the skin due to poor oxygenation of blood. (cyanosis)

Causes of respiratory distress syndrome

NRDS is caused by a lack of surfactant. Surfactant is a substance that helps the lungs expand and contract properly. Babies who are born full term have the required surfactant in the lungs and don’t develop NRDS. Babies who are born prematurely may not have enough surfactant at time of birth, so are at risk of developing NRDS, but within a few days of life their lungs start producing enough surfactant.

How is respiratory distress syndrome diagnosed?

RDS is usually diagnosed based on the baby’s symptoms, clinical examination, oxygen requirement and a chest X-ray.

Neonatal respiratory distress syndrome treatment

The treatment for RDS depends on the severity of the baby’s condition. Babies with mild NRDS may only need non-invasive ventilation and minimal oxygen therapy. Babies with more severe RDS may need to be placed on a ventilator and surfactant replacement therapy.  The call to use surfactant should be taken by a qualified neonatologist.

How can I prevent NRDS?

Prevention of NRDS starts with the participation of the obstetric team. The obstetrician can identify high risk pregnancies which will land up in preterm labor including mothers having previous preterm delivery, twin pregnancy, IVF conception and mothers having medical diseases.  All such mothers can be given antenatal steroids after 24weeks of pregnancy to decrease the incidence of NRDS and decrease the severity of NRDS.

Mother coming in preterm labor should be given medications to arrest labor when possible.

Pregnant women can take steps to reduce their risk of having a premature baby, such as getting regular antenatal checkups and avoiding smoking and alcohol.

Conditions requiring medical attention during delivery

• Mother having past history of preterm labor and delivery
• IVF conception
• Twins/triplet conception
• Mothers with medical illness like diabetes
• Any mother having preterm labor before 30 weeks of gestation

Such a mother should try to deliver the baby in a center having the infrastructure and clinical expertise to manage these babies as the incidence of NRDS will be high.

Consult the best child expert in Navi Mumbai, Dr. Ashok Gawdi, Consultant Pediatrics & Neonatology, Apollo Children’s, Navi Mumbai.

Call 022 6280 6280 for an appointment.