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Premature Babies, Lung Development & Respiratory Distress Syndrome

Premature babies are at risk for respiratory distress at birth. Immature lung tissue can make breathing difficult for premature babies. Respiratory distress most often affects premature babies born before 34 weeks. Approximately ten percent of premature babies experience some degree of respiratory distress.

Lung Development in Premature Babies

Lung tissue matures just prior to birth. Before birth, a baby's lungs are filled and supported with amniotic fluid. Lung tissue usually matures by week 34, so babies can breathe air at birth. Immature lung tissue is unprepared for birth, increasing the chance of respiratory distress.
 
Premature babies lack surfactant , a protein that makes lung tissue elastic. Surfactant prevents the lungs from collapsing, and makes lung inflation easier. Insufficient surfactant leaves respiratory tissue unprotected at birth. Lung tissue may collapse, making breathing difficult. Insufficient lungpower results in low oxygen levels in the blood of premature babies, which in turn leads to respiratory distress.

Delaying Birth to Improve Lung Function

Doctors try to delay premature births as long as possible. Delaying birth gives lung tissue extra time to mature, and improves lung function of premature babies at birth. A delay of just one or two days can improve lung maturity and lower the risk of respiratory distress.
 
During the delay before birth, mothers of premature babies may be prescribed corticosteroids. In some cases, steroids help mature lung tissue before birth. Steroids are powerful medications, and only prescribed in special circumstances.

Symptoms of Respiratory Distress in Premature Babies

Symptoms of respiratory distress may not occur immediately after birth, so premature babies must be carefully monitored. Respiratory distress is a medical emergency requiring prompt treatment.

The following symptoms can indicate respiratory distress:

  • "grunting" noises
  • "odd" movement of chest muscles while breathing
  • cessation of breathing
  • difficulty breathing
  • nasal flaring
  • puffy/swollen extremities
  • shortness of breath.

Respiratory Distress Treatment

After birth, respiratory distress syndrome must receive prompt treatment. Premature babies are monitored carefully for symptoms of respiratory distress. In severe cases of respiratory distress, mechanical ventilation is required to maintain oxygen levels and air pressure in the premature baby's lungs. In select cases, artificial surfactant may be used to treat respiratory distress in premature babies.

Despite the seriousness of respiratory distress, medical research has significantly improved the survival chances of premature babies. Premature babies with immature lung tissue can, and do, grow into healthy children, due in part to advances in respiratory distress treatment.

Resources

Beers, M.H. & Berkow, R. (ed). Normal pregnancy, labor, and delivery. The Merck Manual of Diagnosis and Therapy, 17th Edition. Merck Research Laboratories, NJ, 1999.

Callahan, T.L., Caughey, A.B., Heffner, L.J. (2001). Blueprints in Obstetrics and Gynecology, 2nd Edition. Blackwell Publishing, MA.

John's Hopkin's School of Medicine. (1995). Surfactant.

March of Dimes Birth Defects Foundation. (updated 2005). Complications of premature birth.

Mayo Foundation for Medical Education and Research. (2004). Premature birth.

U.S. National Library of Medicine. (updated 2004). IRDS (Infant respiratory distress syndrome). MedlinePlus Medical Encyclopedia.


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This site is designed to provide information, not medical advice. Please consult your physician if you have any questions or concerns.