ArticleTranslational pediatrics2026
Reassessing bronchopulmonary dysplasia definitions: association between severity grading and brain injury on term-equivalent age MRI.
Article in Translational pediatrics, 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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Abstract
Background: This study aimed to evaluate the associations between severity classified by three bronchopulmonary dysplasia (BPD) diagnostic criteria [2001 National Institute of Child Health and Human Development (NICHD), 2018 NICHD, and 2019 Jensen] and cerebral injury identified on term-equivalent age (TEA) magnetic resonance imaging (MRI) in infants born at <32 weeks' gestation. Methods: This single-center retrospective cohort study included 222 preterm infants (mean gestational age 29.3±1.6 weeks) admitted to Shanghai Children's Hospital [2018-2022]. Brain injury was scored on TEA MRI using the Kidokoro system, yielding white matter (WM), cortical gray matter (GM), deep GM, and cerebellar scores; a global brain abnormality (GBA) score ≥6 defined moderate-to-severe global brain injury (msGBI). We compared brain injury across BPD severity groups for each criterion and analyzed associations between BPD severity and msGBI using Firth's penalized-likelihood regression, adjusting for gestational age and birth weight. Results: WM abnormalities were the most frequent injury (70.3%); msGBI was present in 12.6% of infants. Applying the 2019 Jensen criteria revealed a severity-dependent increase in brain injury scores, with significant differences in GBA, WM, and cortical GM scores across severity groups (all P<0.05). Only grade 3 BPD by the 2019 Jensen criteria was independently associated with msGBI (adjusted odds ratio =8.54, 95% confidence interval: 2.04-37.72, P=0.004). No significant associations were found for the other criteria. Conclusions: The 2019 Jensen criteria uniquely identify a high-risk subgroup (grade 3 BPD) with significantly increased odds of msGBI on TEA MRI, supporting its utility in neurological risk stratification.
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