**Preface to "Neonatal Resuscitation with Placental Circulation Intact"**

Neonatal transitional physiology should include a delay in cord clamping until after the newborn is breathing: this is easy to perform in a healthy term newborn, but not in a sick or preterm newborn. A delayed cord clamping of 30 seconds reduces the hospital mortality of preterm newborns. Very limited data are available on delayed cord clamping in term newborns who require neonatal resuscitation at birth. Resuscitation with an intact cord is feasible and safe, both in term and preterm newborns, and could be the best way to stabilize a newborn in the delivery room. Immediate cord clamping still represents the standard care in very preterm and sick newborns worldwide. To promote a different, more physiological approach to newborns in need of assistance at birth, neonatologists should move close to the delivering mother to evaluate the tone, heart rate, and breathing efforts of the newborn, and at least start the initial steps of stabilization (above all, breathing tactile stimulation) before the cord is clamped. Recent studies have demonstrated that resuscitating a newborn with an intact cord is safely feasible, both with and without the use of special equipment and a movable trolley. However, these special devices still need technological improvements and are too expensive to permit the rapid spread of this approach in delivery room care protocols. The goal of this research topic is to promote the spread of a new way of resuscitating newborns in the delivery room, which comprises performing exactly the same neonatal resuscitation procedures (according to the 2020 neonatal resuscitation guidelines) in a different landscape, that is, at the mother's side with an intact cord. Authors have been invited to contribute to this Special Issue with original research or clinical trial articles, study protocols, brief research, case report articles, and technology and code articles, addressing themes such as the following:

1) Delayed cord clamping, which is longer than 1 minute after the newborn breathes, in preterm babies;

2) Neonatal resuscitation/assistance with an intact cord in preterm newborns;

3) Neonatal resuscitation with an intact cord in asphyxiated term newborns;

4) Neonatal resuscitation with an intact cord in congenital fetal anomalies (hydrops fetalis, diaphragmatic hernia, etc.);

5) Technological advances (trolley, heating system, ventilation system, etc.) to promote neonatal assistance with an intact cord;

6) High-fidelity simulation to promote multiprofessional neonatal assistance with an intact cord;

7) Physiological (hemodynamic and respiratory) neonatal adaptation during an intact cord transition (both animal and human studies).

I am really grateful to all authors for their valuable work, and to David Hutchon and Anup Katheria for their expert assistance as co-Editors of this Special Issue of *Children*. Special thanks to Satyan Lakshminrusimha for making the cover figure for the reprint.

> **Simone Pratesi, David Hutchon, and Anup Katheria** *Editors*
