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Updated: Oct 15, 2026
Development of an Uncomplicated Mild Traumatic Brain Injury Model Modified by Weight-Drop Method and Evidenced by Magnetic Resonance Imaging
Published on: April 11, 2025
Reassessing bronchopulmonary dysplasia definitions: association between severity grading and brain injury on
Su-Hua Xu1, Ting-Ting Li2, Chong-Bing Yan1
1Department of Neonatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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.
