This work aims to investigate and compare the levels of serum endocan and serum copeptin on the first day of life and correlate their levels to the severity of respiratory distress in preterm neonates suffering from respiratory distress syndrome.

Preterm birth continues to be one of the significant challenges in perinatal medicine because of its high incidence of morbidities and mortalities. Its burden on the infant, the family, healthcare systems, and society is enormous.

Endocan is implicated in the recruitment of circulating lymphocytes to inflammatory sites and leukocyte adhesion and activation. Endocan also inhibits leukocyte-endothelial cell adhesion and reduces the excessive leukocyte recruitment into the lungs.

Copeptin, also known as the arginine vasopressin (AVP) associated glycopeptides. AVP is a vasoactive neurohypophysial hormone. It is one of the primary hormones of the hypothalamic-pituitary-adrenal axis, and its primary function is to regulate water and maintain electrolyte homeostasis. The primary stimulus for AVP release is hyperosmolarity.

Inclusion Criteria:

• Prematurity.
• Gestational age between 28 and 36 weeks.
• Suffering from respiratory distress syndrome.

Exclusion Criteria:

• Intrauterine growth restriction (IUGR).
• Hypoxic ischemic encephalopathy.
• Multiple congenital anomalies.
• Chromosomal abnormalities.
• Preterm less than 28 weeks.
• Neonates with a maternal history of chorioamnionitis (early sepsis).
• Infant of diabetic mother.
• Prelabor rupture of membranes (PROM)> 2 hours.

This prospective study will be conducted at the Neonatal Intensive Care Unit (NICU), Pediatric Department, Tanta University Hospitals.

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

After the end of study for one year.

The data will be available upon a reasonable request from the corresponding author.