The main cause of RDS in premature infants is due to an immature pulmonary system which has not developed enough to produce adequate amounts of lung surfactant. Surfactant production begins around 20 weeks gestation and continues until full-term delivery, so if an infant is born before this time they may not have had enough time to develop adequate amounts for proper breathing on their own without assistance. Premature infants are particularly vulnerable because they often weigh less than 2 kgs at birth which further affects their ability to produce sufficient levels of surfactant as well as increasing their risk for other complications such as infection and bronchopulmonary dysplasia (BPD).
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