Management of respiratory distress in late preterm and early-term newborns

Background. Managing respiratory distress in late preterm (LPT) and early-term (ET) newborns remains challenging. Despite being near term, these infants face significant respiratory risks with potential long-term consequences. Perspective. Current management strategies vary widely, with ongoing debate over proactive vs. expectant approaches. While early surfactant administration may be beneficial, evidence remains inconclusive. LPT and ET infants show a higher incidence of asthma and respiratory infections, raising concerns about long-term morbidity. Additionally, the risks of antenatal corticosteroids and unnecessary interventions require careful evaluation. Challenges and future directions. The lack of specific guidelines underscores the need for robust clinical trials, such as SurfON, to clarify optimal treatment. Financial and emotional burdens on families must also be considered. Conclusions. Future guidelines should integrate evidence-based, personalized strategies to reduce practice variability and improve outcomes. Advanced imaging and biomarkers may help refine treatment decisions.