Comparison of the Silverman-Andersen Score and the Downes Score

Inclusion Criteria: * Preterm infants born at \>28 weeks of gestation or term infants born at ≥37 weeks of gestation. * Development of respiratory distress within the first 6 hours after birth, defined as the presence of at least two of the following: Respiratory rate ≥60/min, Subcostal/intercostal retractions, Grunting. * Persistence of respiratory distress for more than 6 hours. * Age within the first 12 hours of life. * Silverman-Andersen score ≥3. * Receiving NIPPV support. Exclusion Criteria: * Major congenital malformations. * Airway or pulmonary anomalies. * Cardiovascular or respiratory instability due to sepsis. * Cyanotic congenital heart disease. * Severe intraventricular hemorrhage. * Contraindications for NIPPV therapy (e.g., congenital nasal anomalies, congenital diaphragmatic hernia, abdominal wall defects). * Requirement of intubation or chest compressions in the delivery room. * Requirement of intubation within the first hour of life. * Death within the first 24 hours of life. * Gestational age ≤28 weeks. * Diagnosis of air leak syndrome (pneumothorax) prior to initiation of NIPPV therapy.