During the early neonatal period, respiratory distress is commonly observed in approximately 7% of infants, with approximately a third of these infants further requiring mechanical ventilation.

Respiratory failure is one of the leading causes of neonatal mortality and morbidity.

Inaccurate assessment of respiratory failure may lead to both adverse outcomes and wasted medical resources required for intensive care.

However, objective assessment of respiratory failure based on physical observation is difficult even for experienced neonatologists.

Precise markers of respiratory distress available at the cot-side may significantly improve the decision to escalate respiratory support and to transfer infants to higher-level units.

Precise estimation of respiratory function is essential to optimise neonatal respiratory care.

However, current clinical scores have not been validated with quantitative measures of respiratory function.

The aim of this study was to develop a physiological scoring system to predict low respiratory dynamic compliance of <0.6 ml/cmH2O/kg.