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Insufficient synthesis of surfactant, a chemical that keeps the lungs' alveoli from collapsing, causes respiratory distress syndrome (RDS), a dangerous lung ailment that is most frequently observed in preterm newborns. Insufficient surfactant causes the lungs to stiffen, which hinders breathing and lowers oxygen exchange. Hyaline membrane illness is another name for respiratory distress syndrome.
Since surfactant production usually rises in the latter stages of pregnancy, prematurity is the main risk factor. Multiple births, caesarean deliveries without labour, and maternal diabetes are further risk factors. Within hours of birth, affected babies typically exhibit cyanosis, nasal flaring, fast breathing, grunting, and chest retractions.

Doctors use clinical indicators, a "ground-glass" appearance on the chest X-ray, and low oxygen levels from the blood gas analysis to diagnose the condition. Continuous positive airway pressure (CPAP), oxygen therapy, or, in extreme situations, mechanical ventilation are all necessary medical interventions for management. Exogenous surfactant administration greatly enhances survival and results.

Prenatal corticosteroids are used as a preventive measure to improve foetal lung maturity in women who are at risk of premature delivery. Although the prognosis for RDS has improved due to advancements in newborn care, severe cases may still result in problems such as chronic lung disease.