Berry MJ, et al. - Researchers performed a retrospective cohort analysis of integrated neonatal medical and surgical care of all infants born between 23⁺⁰ and 24⁺⁶ weeks' gestation admitted to a tertiary level neonatal intensive care unit (NICU) during a 16 year period (2002–2017) for outcomes of periviable infants with gut perforation by gestational age. They identified a total of 198 periviable neonates (73 born at 23 weeks' gestation and 125 born at 24 weeks) who were admitted during the 16-year period. Nearly half of all periviable infants with a gut perforation were reported to have survived. At 2–3 years, no/mild disability was identified in many of these with corrected gestational age. These findings suggest rigid protocols that rely on gestational age alone to guide treatment as inappropriate and support the contention that extremely preterm infants should be born and cared for in units with combined medical and surgical expertise, when possible.