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We aimed to investigate the current practice of neonatal resuscitation by year and analyze the association with neonatal outcomes. A total of 8142 very-low-birth-weight infants, registered in the Korean Neonatal Network between 2014 and 2017 were included.\u00a0A significant decreasing trend of intubation (64.5% vs 55.1%, P\u2009&lt;\u20090.0001) and markedly increasing trend of positive pressure ventilation (PPV) (11.5% vs 22.9%, P\u2009&lt;\u20090.0001) were noted. The annual PPV rate differed significantly by gestation (P\u2009&lt;\u20090.0001). The highest level of resuscitation was also shown as an independent risk factor for mortality within 7\u00a0days and for bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and periventricular leukomalacia. PPV and intubation were associated with significantly decreased risk of mortality and morbidities compared to epinephrine use. When considering association, the incidence of mortality within 7\u00a0days, IVH, PVL, and BPD or mortality showed significant differences by combination of year, gestational age, and level of resuscitation. According to updated guidelines, changes in the highest level of resuscitation significantly associated with reducing mortality and morbidities. More meticulous delivery room resuscitation focusing on extreme prematurity is needed.<\/jats:p>","DOI":"10.1038\/s41598-021-88561-5","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T10:07:24Z","timestamp":1619431644000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of neonatal resuscitation changes on outcomes\u00a0of very-low-birth-weight infants"],"prefix":"10.1038","volume":"11","author":[{"given":"So Jin","family":"Yoon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joohee","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Ho","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Eun","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Seon","family":"Eun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Soo","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kook In","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soon Min","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"key":"88561_CR1","doi-asserted-by":"publisher","first-page":"F102","DOI":"10.1136\/archdischild-2018-314898","volume":"104","author":"T Martherus","year":"2019","unstructured":"Martherus, T. et al. 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