Infant Respiratory Distress Syndrome

Infant respiratory distress syndrome (IRDS), also called neonatal respiratory distress syndrome or respiratory distress syndrome of newborn. It is also known as hyaline membrane disease (HMD), is a syndrome in premature infants caused by developmental insufficiency of surfactant production and structural immaturity in the lungs. Genetic problem with the production of surfactant associated proteins may also cause this disease.

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Premature birth is defined as being born before 37 weeks’ gestation. The lungs of infants born this early can’t produce surfactant, a liquid that coats the lungs and prevents them from collapsing. Most babies with respiratory distress syndrome show signs of breathing problems within the first hours after birth.

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IRDS affects about 1% of newborn infants and is the leading cause of death in preterm infants. The incidence decreases with advancing gestational age, from about 50% in babies born at 26–28 weeks, to about 25% at 30–31 weeks. The syndrome is more frequent in infants of diabetic mothers and in the second born of premature twins.

IRDS is distinct from pulmonary hypoplasia, another leading cause of neonatal death that involves respiratory distress.

The symptoms usually appear within minutes of birth, although they may not be seen for several hours. Symptoms may include:

• Bluish color of the skin and mucus membranes (cyanosis)
• Brief stop in breathing (apnea)
• Decreased urine output
• Grunting
• Nasal flaring
• Rapid breathing
• Shallow breathing
• Shortness of breath and grunting sounds while breathing
• Unusual breathing movement — drawing back of the chest muscles with breathing

Surfaxin (lucinacant) has been approved by the U.S. Food and Drug Administration to prevent respiratory distress syndrome. It is the fifth FDA-approved drug for IRDS, was evaluated in clinical studies involving nearly 1,300 premature infants. Most side effects involved the breathing tube used to administer the drug. Adverse reactions included tube reflux or obstruction, skin paleness and the need for dose interruption. Surfaxin is produced by Discovery Laboratories, of Warrington, Penn.

Related articles

• Discovery Labs Wins Approval with Lung Drug for Premature Infants (wire.kapitall.com)
• FDA Backs Respiratory Distress Drug for Babies – New York Times (nytimes.com)