Background: Respiratory distress syndrome in neonates is life threatening and results in death from
severe respiratory failure. Positioning neonates in a good body alignment is essential to improve
oxygenation and reduce the need for supplemental oxygen and mechanical ventilation. Aim of the
study: The current study aimed to determine the effect of lateral positions versus prone position on
cardiorespiratory parameters among preterm neonates with respiratory distress syndrome. Research
design: A cross-over experimental research design was utilized for this study. Setting: The study
was conducted at the Neonatal Intensive Care Unit at Alexandria University Children's Hospital at
Smouha, Egypt. Subjects: purposive sample of 30 preterm neonates were selected to perform the
current study. Tools: Two tools were used for data collection, Tool I: Characteristics and
cardiorespiratory parameters of preterm neonates' assessment tool, Tool II: Complication detection
record. Results: The values of heart rate, respiratory rate and oxygen saturation improved
significantly among preterm neonates in prone position than in the lateral positions after one and
two hours. Respiratory distress signs were significantly lower in prone position than in lateral
positions after one and two hours. There was no statistical significant difference between the three
positions at zero minute, one hour and two hours regarding complications among preterm neonates.
Conclusion: The study concluded that cardiorespiratory parameters and respiratory distress signs
have improved in prone position more than in lateral positions. Recommendations: Prone position
under nurses' supervision is recommended to be used in the routine care of preterm neonates with
respiratory distress syndrome and educational programs should be conducted to nurses working at
Neonatal Intensive Care Units regarding the benefits and importance of positioning of preterm
neonates.