What is the primary cause of difficulty breathing in newborns affected by NRDS?

In newborns affected by Neonatal Respiratory Distress Syndrome (NRDS), the primary cause of difficulty breathing is a lack of surfactant. Surfactant is a substance produced by cells in the lungs that reduces surface tension in the alveoli, which are the tiny air sacs where gas exchange occurs. In premature infants or those with NRDS, the lungs may not produce enough surfactant, leading to collapsed alveoli and making it difficult for the infant to take in air. This lack of surfactant results in increased work of breathing, reduced lung compliance, and impaired gas exchange, ultimately causing respiratory distress.

This is why the presence of a sufficient amount of surfactant is crucial for normal respiratory function in newborns. Without it, the effort required to breathe increases significantly, and infants struggle to maintain adequate oxygen levels. In contrast, conditions like excess amniotic fluid, infection, and airway obstruction can also lead to respiratory issues, but they do not primarily cause the hallmark feature of NRDS like the lack of surfactant does.