Sinclair R, et al. - Using linked data from New South Wales, Australia for births between 22+0 and 26+6 weeks of gestation between 2000 and 2011, researchers conducted a population based study to determine the association between clinical practice and publication of an Australian consensus statement for management of extremely preterm infants published in 2006. There were 4,746 births, 2,870 of which were liveborn and 1,876 were stillborn. Adjusted odds ratio (OR) for resuscitation was increased by birthweight, tertiary hospital birth and Caesarean delivery and decreased by rural residence and male gender. Between 2004 (52%) and 2005 (20%), fewer than 23 weeks of gestation were resuscitated, but the resuscitation rate increased by 2008 (44%). No difference was found at other gestations. Particularly for 23 week gestation infants, expert recommendations might be shaped by clinical practice instead of converse. The recommendations should be regularly revised to incorporate changes in clinical practice.