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In this issue of Acta Paediatrica, Sinclair et al. (1) describe the relationship between the publication of an Australian expert consensus statement on resuscitating preterm infants born before 26 weeks of gestation and their short-term outcomes. The authors found that the statement, which was published in 2006, had minimal impact on the clinical practices of neonatologists in delivery rooms. This is a very interesting study, because infants born before 26 weeks of gestation show a variety of short-term outcomes due to their marginal viability. Many countries have issued guidelines for resuscitating infants born at each gestational week after 22 weeks in order to avoid nonbeneficial interventions. Although the 2006 Australian guidelines recommended that infants born at 22–23 weeks of gestation should not be resuscitated, the resuscitation rate for infants born at 23 weeks of gestation had fallen to 20% in 2005 but had increased to 44% in 2008. So why was this expert consensus statement not appreciated and implemented under clinical conditions in Australia?

More studies are needed to convince stakeholders of the value of resuscitating periviable infants