**Core Concept**
Respiratory distress syndrome (RDS), also known as hyaline membrane disease, is a condition primarily affecting premature infants characterized by difficulty breathing due to surfactant deficiency in the lungs. It leads to atelectasis and impaired gas exchange.

**Why the Correct Answer is Right**
Surfactant is a complex mixture of phospholipids and proteins produced by type II pneumocytes in the lungs, which reduces surface tension and facilitates lung expansion during inhalation. Premature infants often lack sufficient surfactant production, leading to alveolar collapse and respiratory distress. The pathophysiology of RDS involves the imbalance between the production and clearance of surfactant. In RDS, there is a deficiency of surfactant protein B (SP-B), which plays a crucial role in surfactant function.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as surfactant deficiency is a hallmark of respiratory distress syndrome (RDS).
**Option B:** This option is incorrect as premature infants are indeed at higher risk of developing RDS due to surfactant deficiency.
**Option C:** This option is incorrect as surfactant replacement therapy is a standard treatment for RDS in premature infants.

**Clinical Pearl / High-Yield Fact**
To remember the causes of RDS, use the mnemonic "PPROM": Premature birth, Pulmonary immaturity, Premature rupture of membranes. This will help you associate the risk factors with the condition.

**Correct Answer:** A.