Abstract
Respiratory Distress Syndrome (RDS) remains a major cause of morbidity and mortality in preterm neonates, particularly in resource- limited Level 2 Special Newborn Care Units. Therefore, it is of interest to analyse outcomes of 308 preterm neonates treated with early Continuous Positive Airway Pressure (CPAP) or combined CPAP-surfactant therapy across three gestational age groups. Survival was highest with CPAP alone in moderate and late preterm neonates (31-36 weeks), reaching 84.4%-87.3%. Extremely preterm neonates (27-30 weeks) showed improved outcomes with early selective surfactant plus CPAP, though mortality remained higher due to pulmonary hemorrhage and sepsis. Early CPAP is highly effective for 31-36-week neonates, while extremely preterm infants benefit most from combined CPAP-surfactant therapy.