Surfactant in Late Preterm Infants

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.