Preterm neonates are susceptible to neonatal respiratory distress syndrome (NRDS). Lower levels of cord blood vascular endothelial growth factor () are implicated in NRDS. This study aims to explore whether the serum level has prognostic values on neonates with respiratory distress syndrome (RDS). A total of 80 infants diagnosed with NRDS were enrolled, with 70 preterm neonates without NRDS as controls. Cord blood samples before treatment and venous blood samples after treatment were collected and clinical information was recorded. The serum level was measured using enzyme-linked immunosorbent assay kits. Receiver operating characteristic (ROC) curve was used to evaluate whether serum is a biomarker of NRDS. Newborns were followed up for 1 month to collect survival information. The influence of levels on overall survival was analyzed using the Kaplan-Meier method. The univariate and multivariate Cox regression models were adopted to assess the prognostic factor of NRDS. level was decreased in sera of neonates with RDS. The area under the ROC curve of level in distinguishing neonates with RDS from neonates without RDS was 0.949, with a cutoff value of 39.72 (87.50% sensitivity, 87.14% specificity). Serum was a biomarker of NRDS. Neonates with RDS with high levels had longer periods of survival than those with low levels. NRDS grade and level were independent prognostic factors affecting the overall survival of neonates with RDS. Decreased serum level in RDS neonates can predict the poor prognosis of NRDS, and level might be an independent prognostic factor for the overall survival of RDS neonates. Clinical Trial Registration No. 201901A.

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