Respiratory Distress Syndrome (RDS) of the newborn is a common problem that affects premature babies. It is caused by a lack of surfactant, which is a substance in the lungs that helps keep them open and allows oxygen to pass through. Without enough surfactant in the lungs, infants have difficulty breathing and may require mechanical ventilation for support. The primary cause of RDS of the newborn is prematurity or immaturity of the lungs at birth.

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).