In Reply In their letter, Groenendaal and coauthors inform us about recent changes in attitudes and practice regarding the care of extremely preterm babies in the Netherlands resulting in optional active resuscitation for neonates from a gestational age of 24 weeks onwards. That is important news. We hope that they will soon publish these data internationally in a detailed manner and include the descriptions of medical care and the decisions that preceded the death or survival of the babies studied. That would help us to understand what we can validly infer from comparison with other outcome studies.