---
title: "Surfactant Use for Respiratory Distress in Late Preterm Infants"
id: "pubmed-42674609"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674609"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674609/"
doi: "10.1542/neo.27-9-049"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Surfactant Use for Respiratory Distress in Late Preterm Infants
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674609
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674609/)
- **DOI:** [10.1542/neo.27-9-049](https://doi.org/10.1542%2Fneo.27-9-049)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Late preterm infants (LPIs) experience respiratory distress syndrome (RDS) with reported incidence varying across studies from **8% to 30.6%**. - There is an absence of standardized guidelines for managing RDS in LPIs; clinical practice around **surfactant** therapy is highly variable. - Key uncertainties include which clinical criteria should trigger surfactant therapy, the optimal **timing** of administration, and the preferred **mode of delivery** in this population. - **Antenatal steroids** may play a preventive role for RDS in LPIs; the review summarizes current evidence on this intervention. - Surfactant administration is considered **time-sensitive**, but clinicians lack consensus on when to give surfactant to LPIs. - The review examines the pathophysiology of RDS specific to LPIs and compiles existing evidence on therapeutic approaches. - The article highlights gaps in evidence and variation in practice, indicating a need for clearer clinical criteria and consensus recommendations. - Specific details on dosing, comparative outcomes, or definitive timing thresholds were not fully reported in the abstract and would require consultation of the full review.
## Clinical Analysis & Structured Key Points
Clipboard, Search History, and several other advanced features are temporarily unavailable. [ Skip to main page content ](https://pubmed.ncbi.nlm.nih.gov/42674609/#article-details) ![U.S. flag](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png) An official website of the United States government Here's how you know ![Dot gov](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg) **The .gov means it’s official.** Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site. ![Https](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg) **The site is secure.** The **https://** ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. [ ![NIH NLM Logo](https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/logos/AgencyLogo.svg) ](https://www.ncbi.nlm.nih.gov/) [Log in](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674609%2F) Show account info Close #### Account Logged in as: **username** * [Dashboard](https://www.ncbi.nlm.nih.gov/myncbi/) * [Publications](https://www.ncbi.nlm.nih.gov/myncbi/collections/bibliography/) * [Account settings](https://www.ncbi.nlm.nih.gov/account/settings/) * [Log out](https://www.ncbi.nlm.nih.gov/account/signout/?back_url=https%3A//pubmed.ncbi.nlm.nih.gov/42674609/) [Access keys](https://www.ncbi.nlm.nih.gov/guide/browsers/#ncbi_accesskeys) [NCBI Homepage](https://www.ncbi.nlm.nih.gov) [MyNCBI Homepage](https://pubmed.ncbi.nlm.nih.gov/myncbi/) [Main Content](https://pubmed.ncbi.nlm.nih.gov/42674609/#maincontent) [Main Navigation](https://pubmed.ncbi.nlm.nih.gov/42674609/) [ ![pubmed logo](https://cdn.ncbi.nlm.nih.gov/pubmed/af7de7da-df5d-41c6-8de4-8c266af8ccfb/core/images/pubmed-logo-blue.svg) ](https://pubmed.ncbi.nlm.nih.gov/) [ ](https://pubmed.ncbi.nlm.nih.gov/42674609/ "Show search bar") Search: [](https://pubmed.ncbi.nlm.nih.gov/42674609/ "Clear search input")Search [Advanced](https://pubmed.ncbi.nlm.nih.gov/advanced/) [ Clipboard ](https://pubmed.ncbi.nlm.nih.gov/clipboard/) [ User Guide ](https://pubmed.ncbi.nlm.nih.gov/help/) Save Email Send to * [ Clipboard ](https://pubmed.ncbi.nlm.nih.gov/42674609/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674609%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674609%2F%23open-collections-panel) * [Citation manager](https://pubmed.ncbi.nlm.nih.gov/42674609/) Display options Display options Format Abstract PubMed PMID ## Save citation to file Format: Summary (text) PubMed PMID Abstract (text) CSV Create file Cancel ## Email citation Email address has not been verified. Go to [ My NCBI account settings ](https://account.ncbi.nlm.nih.gov/settings/) to confirm your email and then refresh this page. To: Subject: Body: Format: Summary Summary (text) Abstract Abstract (text) MeSH and other data Send email Cancel ### Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42674609/) Add Cancel ### Add to My Bibliography * My Bibliography Unable to load your delegates due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42674609/) Add Cancel ## Your saved search Name of saved search: Search terms: [Test search terms](https://pubmed.ncbi.nlm.nih.gov/42674609/) Would you like email updates of new search results? Saved Search Alert Radio Buttons * Yes * No Email: ([change](https://www.ncbi.nlm.nih.gov/account/settings/)) Frequency: Monthly Weekly Daily Which day? The first Sunday The first Monday The first Tuesday The first Wednesday The first Thursday The first Friday The first Saturday The first day The first weekday Which day? Sunday Monday Tuesday Wednesday Thursday Friday Saturday Report format: Summary Summary (text) Abstract Abstract (text) PubMed Send at most: 1 item 5 items 10 items 20 items 50 items 100 items 200 items Send even when there aren't any new results Optional text in email: Save Cancel ## Create a file for external citation management software Create file Cancel ## Your RSS Feed Name of RSS Feed: Number of items displayed: 5 10 15 20 50 100 Create RSS Cancel RSS Link Copy ### Actions Cite Collections Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42674609/) Add Cancel Permalink Permalink Copy Display options Display options Format Abstract PubMed PMID ### Page navigation * [ Title & authors ](https://pubmed.ncbi.nlm.nih.gov/42674609/#heading) * [ Abstract ](https://pubmed.ncbi.nlm.nih.gov/42674609/#abstract) * [ Publication types ](https://pubmed.ncbi.nlm.nih.gov/42674609/#publication-types) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42674609/#mesh-terms) * [ Substances ](https://pubmed.ncbi.nlm.nih.gov/42674609/#substances) Title & authors Abstract Publication types MeSH terms Substances Review Neoreviews Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Neoreviews%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Neoreviews%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) . 2026 Sep 1;27(9):e571-e580. doi: 10.1542/neo.27-9-049. # Surfactant in Late Preterm Infants [Bianca R Davis](https://pubmed.ncbi.nlm.nih.gov/?term=Davis+BR&cauthor_id=42674609)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674609/#full-view-affiliation-1 "School of Medicine, University of Missouri, Columbia, Missouri."), [Nicole V Sewall](https://pubmed.ncbi.nlm.nih.gov/?term=Sewall+NV&cauthor_id=42674609)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674609/#full-view-affiliation-1 "School of Medicine, University of Missouri, Columbia, Missouri."), [Akshaya J Vachharajani](https://pubmed.ncbi.nlm.nih.gov/?term=Vachharajani+AJ&cauthor_id=42674609)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674609/#full-view-affiliation-2 "Department of Pediatrics, University of Missouri, Columbia, Missouri.") Affiliations Expand ### Affiliations * 1 School of Medicine, University of Missouri, Columbia, Missouri. * 2 Department of Pediatrics, University of Missouri, Columbia, Missouri. * PMID: **42674609** * DOI: [ 10.1542/neo.27-9-049 ](https://doi.org/10.1542/neo.27-9-049) Item in Clipboard Review # Surfactant in Late Preterm Infants Bianca R Davis et al. Neoreviews. 2026. Show details Display options Display options Format Abstract PubMed PMID Neoreviews Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Neoreviews%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Neoreviews%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) . 2026 Sep 1;27(9):e571-e580. doi: 10.1542/neo.27-9-049. ### Authors [Bianca R Davis](https://pubmed.ncbi.nlm.nih.gov/?term=Davis+BR&cauthor_id=42674609)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674609/#short-view-affiliation-1 "School of Medicine, University of Missouri, Columbia, Missouri."), [Nicole V Sewall](https://pubmed.ncbi.nlm.nih.gov/?term=Sewall+NV&cauthor_id=42674609)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674609/#short-view-affiliation-1 "School of Medicine, University of Missouri, Columbia, Missouri."), [Akshaya J Vachharajani](https://pubmed.ncbi.nlm.nih.gov/?term=Vachharajani+AJ&cauthor_id=42674609)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674609/#short-view-affiliation-2 "Department of Pediatrics, University of Missouri, Columbia, Missouri.") ### Affiliations * 1 School of Medicine, University of Missouri, Columbia, Missouri. * 2 Department of Pediatrics, University of Missouri, Columbia, Missouri. * PMID: **42674609** * DOI: [ 10.1542/neo.27-9-049 ](https://doi.org/10.1542/neo.27-9-049) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract Despite an incidence ranging from 8% to 30.6% across various studies, a lack of guidelines about the management of respiratory distress syndrome (RDS) in late preterm infants (LPIs) exists. Clinical criteria for surfactant therapy and mode of administration remain highly variable in this population. Although surfactant administration is time-sensitive, there is no clear consensus among clinicians on the optimal timing of administration in LPIs. In this review, we summarize the current evidence of the role of antenatal steroids in the prevention of RDS in LPIs, examine current understanding of the pathophysiology of RDS in this population, and review clinical criteria, ideal timing, and mode of surfactant administration. Copyright © 2026 by the American Academy of Pediatrics. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Publication types * Review Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Review%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Review) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) ## MeSH terms * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) * Infant, Newborn Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Infant%2C+Newborn%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Infant%2C+Newborn) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) * Infant, Premature* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Infant%2C+Premature%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Infant%2C+Premature) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) * Pulmonary Surfactants* / administration & dosage Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Pulmonary+Surfactants%2Fadministration+and+dosage%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Pulmonary+Surfactants) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) * Pulmonary Surfactants* / therapeutic use Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Pulmonary+Surfactants%2Ftherapeutic+use%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Pulmonary+Surfactants) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) * Respiratory Distress Syndrome, Newborn* / drug therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Respiratory+Distress+Syndrome%2C+Newborn%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Respiratory+Distress+Syndrome%2C+Newborn) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) * Respiratory Distress Syndrome, Newborn* / physiopathology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Respiratory+Distress+Syndrome%2C+Newborn%2Fphysiopathology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Respiratory+Distress+Syndrome%2C+Newborn) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) * Respiratory Distress Syndrome, Newborn* / prevention & control Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Respiratory+Distress+Syndrome%2C+Newborn%2Fprevention+and+control%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Respiratory+Distress+Syndrome%2C+Newborn) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) ## Substances * Pulmonary Surfactants Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Pulmonary+Surfactants%22%5Bnm%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=%22Pulmonary+Surfactants%22) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674609/) [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To** * [Clipboard](https://pubmed.ncbi.nlm.nih.gov/42674609/) * [Email](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674609%2F%23open-email-panel) * [Save](https://pubmed.ncbi.nlm.nih.gov/42674609/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674609%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674609%2F%23open-collections-panel) * [Citation Manager](https://pubmed.ncbi.nlm.nih.gov/42674609/) [x] NCBI Literature Resources [MeSH](https://www.ncbi.nlm.nih.gov/mesh/) [PMC](https://www.ncbi.nlm.nih.gov/pmc/) [Bookshelf](https://www.ncbi.nlm.nih.gov/books) [Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited. Follow NCBI [ Twitter ](https://twitter.com/ncbi) [ Facebook ](https://www.facebook.com/ncbi.nlm) [ LinkedIn ](https://www.linkedin.com/company/ncbinlm) [ GitHub ](https://github.com/ncbi) [ ](https://ncbiinsights.ncbi.nlm.nih.gov/) [Connect with NLM](https://www.nlm.nih.gov/socialmedia/index.html) * [ Twitter ](https://twitter.com/NLM_NIH) * [ SM-Facebook ](https://www.facebook.com/nationallibraryofmedicine) * [ SM-Youtube ](https://www.youtube.com/user/NLMNIH) National Library of Medicine [8600 Rockville Pike Bethesda, MD 20894](https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/@38.9959508,-77.101021,17z/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323) [Web Policies](https://www.nlm.nih.gov/web_policies.html) [FOIA](https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office) [HHS Vulnerability Disclosure](https://www.hhs.gov/vulnerability-disclosure-policy/index.html) [Help](https://support.nlm.nih.gov/?pagename=pubmed%3Apubmed%3Aabstract%3ANONE) [Accessibility](https://www.nlm.nih.gov/accessibility.html) [Careers](https://www.nlm.nih.gov/careers/careers.html) * [NLM](https://www.nlm.nih.gov/) * [NIH](https://www.nih.gov/) * [HHS](https://www.hhs.gov/) * [USA.gov](https://www.usa.gov/)
## Related Clinical Research

- [Adult-Onset Langerhans Cell Histiocytosis: Two Cases with Calvarial and Hypothalamic Involvement](https://medichelpline.com/clinical-feed/pubmed-42669941.md)
- [Right ventricular dilatation on echocardiography predicts mortality in hospitalized COVID-19 patie](https://medichelpline.com/clinical-feed/pubmed-42626049.md) (DOI: 10.5662/wjm.v16.i3.117845)
- [Impact of Medicaid Meal Deliveries Facing Budget Cuts and Policy Challenges](https://medichelpline.com/clinical-feed/kff-health-news-0-cost-saving-medicaid-meal-deliveries-threatened-by-cuts-policy-uncertainty.md)
- [Persistent critical illness in mechanically ventilated acute hypoxic respiratory failure: prevalen](https://medichelpline.com/clinical-feed/plos-one-9-persistent-critical-illness-in-acute-hypoxic-respiratory-failure-a.md)
- [Digital Automation for Scalable, Zero-Cost Mechanical Ventilation Assessment](https://medichelpline.com/clinical-feed/medrxiv-5-zero-cost-digital-automation-for-scalable-assessment-in-a-national-mechanical.md)

## Navigation
- [← Back to Critical Care Feed](https://medichelpline.com/clinical-feed/critical-care.md)
- [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md)
## Medical & Regulatory Disclaimer

> [!CAUTION]
> MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations.
> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.