{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:17:56Z","timestamp":1788221876047,"version":"build-2803163510"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:p>Despite an incidence ranging from 8% to 30.6% across\u00a0various 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\u00a0optimal\u00a0timing 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.<\/jats:p>","DOI":"10.1542\/neo.27-9-049","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:04:21Z","timestamp":1788221061000},"page":"e571-e580","source":"Crossref","is-referenced-by-count":0,"title":["Surfactant in Late Preterm Infants"],"prefix":"10.1542","volume":"27","author":[{"given":"Bianca R.","family":"Davis","sequence":"first","affiliation":[{"name":"1School of Medicine, University of Missouri, Columbia, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole V.","family":"Sewall","sequence":"additional","affiliation":[{"name":"1School of Medicine, University of Missouri, Columbia, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshaya J.","family":"Vachharajani","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, University of Missouri, Columbia, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"2026083120041980600_r1","doi-asserted-by":"crossref","first-page":"685016","DOI":"10.3389\/fped.2021.685016","article-title":"Maternal and perinatal determinants of late hospital discharge among late preterm infants; a 5-year cross-sectional analysis","volume":"9","author":"Khasawneh","year":"2021","journal-title":"Front Pediatr."},{"issue":"4","key":"2026083120041980600_r2","doi-asserted-by":"crossref","first-page":"345","DOI":"10.23736\/S0026-4946.16.04580-1","article-title":"Respiratory morbidity in late preterm infants","volume":"70","author":"Correia","year":"2018","journal-title":"Minerva Pediatr."},{"issue":"8","key":"2026083120041980600_r3","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1515\/jpm-2015-0113","article-title":"Neonatal morbidities and need for intervention in twins and singletons born at 34\u201335\u00a0weeks of gestation","volume":"44","author":"Simchen","year":"2016","journal-title":"J Perinat Med."},{"issue":"5","key":"2026083120041980600_r4","doi-asserted-by":"crossref","first-page":"100408","DOI":"10.1016\/j.ajogmf.2021.100408","article-title":"Race and neonatal respiratory morbidity in the late preterm period","volume":"3","author":"Andrikopoulou","year":"2021","journal-title":"Am J Obstet Gynecol MFM."},{"key":"2026083120041980600_r5","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jpeds.2018.05.037","article-title":"Respiratory compliance in late preterm infants (34 0\/7\u201334 6\/7\u00a0weeks) after antenatal steroid therapy","volume":"201","author":"Go","year":"2018","journal-title":"J Pediatr."},{"issue":"1","key":"2026083120041980600_r6","doi-asserted-by":"crossref","first-page":"e003557","DOI":"10.1136\/bmjpo-2025-003557","article-title":"Respiratory distress in late-preterm neonates: from controversy to consensus - a survey of regional advisory boards and neonatologists in France","volume":"9","author":"Hascoet","year":"2025","journal-title":"BMJ Paediatr Open."},{"issue":"14","key":"2026083120041980600_r7","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1056\/NEJMoa1516783","article-title":"Antenatal betamethasone for women at risk for late preterm delivery","volume":"374","author":"Gyamfi-Bannerman","year":"2016","journal-title":"N Engl J Med."},{"issue":"1","key":"2026083120041980600_r8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000528914","article-title":"European consensus guidelines on the management of respiratory distress syndrome: 2022 Update. Neonatology","volume":"120","author":"Sweet","year":"2023","journal-title":"Neonatology."},{"key":"2026083120041980600_r9","doi-asserted-by":"crossref","first-page":"114644","DOI":"10.1016\/j.jpeds.2025.114644","article-title":"Biochemical features and clinical factors influencing response to surfactant treatment among infants born late preterm with respiratory distress syndrome","volume":"284","author":"Lanciotti","year":"2025","journal-title":"J Pediatr."},{"issue":"3","key":"2026083120041980600_r10","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s00431-020-03806-1","article-title":"Surfactant use in late preterm infants: a survey among Belgian neonatologists","volume":"180","author":"Cornette","year":"2021","journal-title":"Eur J Pediatr."},{"issue":"4","key":"2026083120041980600_r11","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1136\/archdischild-2021-322890","article-title":"Surfactant therapy in late preterm and term neonates with respiratory distress syndrome: a systematic review and meta-analysis","volume":"107","author":"Ramaswamy","year":"2022","journal-title":"Arch Dis Child Fetal Neonatal Ed."},{"issue":"10","key":"2026083120041980600_r12","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1111\/jpc.15587","article-title":"Minimally invasive surfactant therapy for moderate to late premature neonates with respiratory distress syndrome born in a non-tertiary unit","volume":"57","author":"Tinoco Mendoza","year":"2021","journal-title":"J Paediatr Child Health."},{"issue":"8","key":"2026083120041980600_r13","doi-asserted-by":"crossref","first-page":"e71257","DOI":"10.1002\/ppul.71257","article-title":"Effectiveness of a respiratory care protocol including less invasive surfactant administration in \u2265\u200935\u00a0weeks gestational age infants","volume":"60","author":"Chotzoglou","year":"2025","journal-title":"Pediatr Pulmonol."},{"issue":"5","key":"2026083120041980600_r14","doi-asserted-by":"crossref","first-page":"e2413446","DOI":"10.1001\/jamanetworkopen.2024.13446","article-title":"Quantitative lung ultrasonography to guide surfactant therapy in neonates born late preterm and later","volume":"7","author":"De Luca","year":"2024","journal-title":"JAMA Netw Open."},{"issue":"12","key":"2026083120041980600_r15","doi-asserted-by":"crossref","first-page":"3244","DOI":"10.1111\/apa.70250","article-title":"Maternal oncological disease and congenital pneumonia are new independent risk factors for surfactant requirements in late preterm infants","volume":"114","author":"Costa","year":"2025","journal-title":"Acta Paediatr."},{"issue":"5","key":"2026083120041980600_r16","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.arcped.2021.03.010","article-title":"Respiratory distress management in moderate and late preterm infants: The NEOBS Study","volume":"28","author":"Debillon","year":"2021","journal-title":"Arch Pediatr."},{"issue":"10","key":"2026083120041980600_r17","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1080\/14767058.2017.1313828","article-title":"Effects of surfactant treatment in late preterm infants with respiratory distress syndrome","volume":"31","author":"Dani","year":"2018","journal-title":"J Matern Fetal Neonatal Med."},{"key":"2026083120041980600_r18","doi-asserted-by":"crossref","first-page":"100320","DOI":"10.1016\/j.resplu.2022.100320","article-title":"Continuous positive airway pressure for term and \u226534+0\u00a0weeks\u2019 gestation newborns at birth: A systematic review","volume":"12","author":"Shah","year":"2022","journal-title":"Resusc Plus."},{"issue":"2","key":"2026083120041980600_r19","doi-asserted-by":"crossref","first-page":"e2021055994","DOI":"10.1542\/peds.2021-055994","article-title":"Variation and temporal trends in delivery room management of moderate and late preterm infants","volume":"150","author":"Handley","year":"2022","journal-title":"Pediatrics."},{"issue":"3","key":"2026083120041980600_r20","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1111\/apa.13644","article-title":"Survey of noninvasive respiratory support practices in Canadian neonatal intensive care units","volume":"106","author":"Mukerji","year":"2017","journal-title":"Acta Paediatr."},{"issue":"11","key":"2026083120041980600_r21","doi-asserted-by":"crossref","first-page":"2970","DOI":"10.1002\/ppul.25054","article-title":"A survey on criteria for intubation in moderate to late preterm infants with respiratory distress","volume":"55","author":"Feng","year":"2020","journal-title":"Pediatr Pulmonol."},{"issue":"12","key":"2026083120041980600_r22","first-page":"CD005384","article-title":"Early nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants","volume":"12","author":"Lemyre","year":"2016","journal-title":"Cochrane Database Syst Rev."},{"issue":"2","key":"2026083120041980600_r23","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ymgme.2009.01.015","article-title":"An overview of pulmonary surfactant in the neonate: genetics, metabolism, and the role of surfactant in health and disease","volume":"97","author":"Nkadi","year":"2009","journal-title":"Mol Genet Metab."},{"issue":"3","key":"2026083120041980600_r24","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s41669-023-00399-x","article-title":"Health economic studies of surfactant replacement therapy in neonates with respiratory distress syndrome: a systematic literature review","volume":"7","author":"Magni","year":"2023","journal-title":"PharmacoEconom Open."},{"issue":"12","key":"2026083120041980600_r25","doi-asserted-by":"crossref","first-page":"5661","DOI":"10.1007\/s00431-023-05259-8","article-title":"Management of respiratory distress in moderate and late preterm infants: clinical trajectories in the NEOBS study","volume":"182","author":"Guellec","year":"2023","journal-title":"Eur J Pediatr."},{"issue":"8","key":"2026083120041980600_r26","doi-asserted-by":"crossref","first-page":"502161","DOI":"10.1016\/j.medin.2025.502161","article-title":"Does early surfactant improve outcome in late preterm newborn? Retrospective study in a neonatal intensive care unit","volume":"49","author":"Bartual Bardisa","year":"2025","journal-title":"Med Intensiva (Engl Ed)."},{"issue":"5","key":"2026083120041980600_r27","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1159\/000518986","article-title":"Surfactant treatment of late preterm infants during emergency transport: a retrospective, observational study","volume":"118","author":"Cavallin","year":"2021","journal-title":"Neonatology."},{"issue":"1","key":"2026083120041980600_r28","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13063-025-09271-1","article-title":"SurfON trial: study protocol for a multicentre, open-label, randomised controlled trial of early surfactant therapy versus expectant management in late preterm and early term infants with respiratory distress","volume":"27","author":"Boyle","year":"2025","journal-title":"Trials."},{"issue":"3","key":"2026083120041980600_r29","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1111\/jpc.16777","article-title":"Risk factors in addition to short and long-term outcomes with thin catheter surfactant administration failure in preterm infants: a retrospective analysis","volume":"61","author":"Kutman","year":"2025","journal-title":"J Paediatr Child Health."}],"container-title":["NeoReviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/neoreviews\/article-pdf\/27\/9\/e571\/1954092\/neoreviews.122025cmerev00214.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/neoreviews\/article-pdf\/27\/9\/e571\/1954092\/neoreviews.122025cmerev00214.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:04:24Z","timestamp":1788221064000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/neoreviews\/article\/27\/9\/e571\/208764\/Surfactant-in-Late-Preterm-Infants"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":29,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,1]]},"published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/neo.27-9-049","relation":{},"ISSN":["1526-9906"],"issn-type":[{"value":"1526-9906","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}