Neonatal respiratory distress syndrome

A 1-day-old boy is brought to the intensive care unit from the nursery due to increased work of breathing. The patient was born at 31 weeks to a mother with a history of multiple preterm deliveries, polysubstance abuse and HIV. His temperature is 38°C (100.4°F), pulse is 215/min, respirations are 76/min, blood pressure is 60/41 mmHg, and oxygen saturation is 85% on room air. Physical exam shows tachypnea, nasal flaring, and subcostal retractions. Administration of supplemental oxygen and positive pressure ventilation improve the patient's oxygen saturation to 95%. Blood glucose is 95 mg/dL. Chest x-ray and laboratory results are shown below:  

 
Reproduced from: Wikipedia
 

Laboratory value	Result
Blood Gases, Serum
pH	7.23
PCO2	55 mmHg
PO2	30 mmHg

Which of the following best describes the etiology of this infant’s disease process?