In South Korea, appropriate prenatal and postnatal management for preterm birth is performed. In addition to current management, further review about surfactant treatment for preterm infants who are subject to reimbursement prophylactic use of surfactants is needed in consideration of prenatal management (e.g., steroid use), delivery environment (presence of medical staff, facility, and equipment for resuscitation and stabilization in the delivery room), and patient’s state immediately after birth (need for endotracheal intubation, infection). 

This study aims to compare selective and prophylactic surfactant administration in terms of their clinical effects, such as clinical progress and mortality, in preterm infants who often have RDS based on a systematic review and data from the Korean Neonatal Network (KNN).