ArticleBMJ open respiratory research2026
Association of birth weight Z-score with bronchopulmonary dysplasia or mortality in very preterm infants: a cohort study.
Article in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundBirth weight (BW) Z-score is associated with outcomes in very preterm infants (VPIs). This study aimed to investigate the association between BW Z-score and the adverse outcomes in VPIs.
methodsThis retrospective cohort study included VPIs admitted to a tertiary neonatal intensive care unit between 1 January 2014 and 31 December 2023. Restricted cubic splines and multivariable logistic regression models were employed to assess associations between BW Z-score and primary outcomes. Infants were categorised based on the identified turning point of Z=-0.35 in the Z-score distribution, where the risk gradient changed most sharply. The primary outcome was bronchopulmonary dysplasia (BPD) or mortality at 36 weeks postmenstrual age or discharge.
resultsAmong 4632 included VPIs, a turning point at Z=-0.35 was identified. Compared with those with Z≥-0.35, VPIs with Z<-1 exhibited higher risks of primary outcomes (OR 3.10, 95% CI 2.53 to 3.79), while those with BW Z-score between -1 and -0.35 also showed increased risks (OR 1.81, 95% CI 1.52 to 2.15). Subgroup and sensitivity analyses further supported the robustness of these findings.
conclusionCompared with BW Z-score above -0.35, both substantially negative BW Z-score<-1 and moderate lower BW Z-score between -1 and -0.35 are associated with increased risk of BPD and mortality in VPIs. The findings underscore the importance of considering BW Z-score as a continuous variable in risk stratification and management of VPIs.
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