Cognitive impairment is independently related to low birth weight, low birth length and small head circumference. SGA children who have not experienced height and / or head circumference catch-up have the worst cognitive function. The serum IGF-1 level of short SGA children is significantly lower than that of catch-up SGA children. This may be due to the defect of GH-IGF-1 axis, resulting in some hGH / IGF-1 deficiency. GH treatment can induce catch-up growth of head circumference, especially for those with small birth head circumference, growth hormone can help to improve IQ, behavior and self cognition of children with SGA. Two years after birth is the most critical period for children's physical, neurological, cognitive and emotional development. This study evaluated the effect of growth hormone treatment on the improvement of cognitive function and growth and development of symmetrical SGA children who did not show catch-up growth from 6 months to 2 years old. This is an innovative study. The minimum age of previous similar studies is 19 months. The starting age of this study is 6 months, and the results are to improve the cognitive development of SGA infants. This is the first of its kind. Although the safety of growth hormone in SGA infants younger than 2 years old has not been reported, it is based on a number of studies on the application of growth hormone in infants, such as PWS and GHD, It can be expected that there will be no short-term and long-term adverse reactions. The study was conducted in 17 hospitals led by Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology
Subjects: SGA children from 6 months to 2 years old who meet the enrollment conditions shall be informed of the enrollment by the researcher and the subject's guardian, and the subject's guardian shall decide to participate in the test drug group or the control group. GH treatment group (n = 68): the subjects were given PEG-rhGH injection 0.2 mg / kg / week (initial dose), once a week, subcutaneously before going to bed for 104 weeks. Each follow-up, the researchers adjusted the dosage according to the IGF-1 results of the center and other individual conditions. Control group (n = 68): no treatment, only follow-up examination and growth and development related evaluation, and the follow-up time was 104 Week.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
138
the subjects were given PEG-rhGH injection 0.2 mg / kg / week (initial dose), once a week, subcutaneously before going to bed for 104 weeks. Each follow-up, the researchers adjusted the dosage according to the IGF-1 results of the center and other individual conditions.
Wuhan Tongji Hospital
Wuhan, Wuhan, China
RECRUITINGtotal development quotient (GQ)
The changes of total development quotient (GQ) of young SGA children were calculated according to Griffiths mental development scale before and after treatment.(The Griffiths Scales,The normal range is from the 16th percentile to the 84th percentile of children of the same age. 100 is the mean. The higher the score, the better)
Time frame: 104 weeks
head circumference SDS
Changes of head circumference SDS in young SGA children before and after treatment
Time frame: 104 weeks
Motor domain development quotient
Changes of motor domain development quotient (AQ) calculated according to Griffiths mental development scale before and after treatment.(The Griffiths Scales,The normal range is from the 16th percentile to the 84th percentile of children of the same age. 100 is the mean. The higher the score, the better)
Time frame: 104 weeks
Personal and social domain development quotient
Changes of personal and social domain development quotient (BQ) calculated according to Griffiths mental development scale before and after treatment.(The Griffiths Scales,The normal range is from the 16th percentile to the 84th percentile of children of the same age. 100 is the mean. The higher the score, the better)
Time frame: 104 weeks
Hearing and language domain development quotient
Changes of hearing and language domain development quotient (CQ) calculated according to Griffiths mental development scale before and after treatment.(The Griffiths Scales,The normal range is from the 16th percentile to the 84th percentile of children of the same age. 100 is the mean. The higher the score, the better)
Time frame: 104 weeks
Hand eye coordination domain development quotient
Changes of hand eye coordination domain development quotient (DQ) calculated according to Griffiths mental development scale before and after treatment.(The Griffiths Scales,The normal range is from the 16th percentile to the 84th percentile of children of the same age. 100 is the mean. The higher the score, the better)
Time frame: 104 weeks
Operation domain development quotient
Changes of operation domain development quotient (EQ) calculated according to Griffiths mental development scale before and after treatment.(The Griffiths Scales,The normal range is from the 16th percentile to the 84th percentile of children of the same age. 100 is the mean. The higher the score, the better)
Time frame: 104 weeks
Reasoning domain development quotient
Changes of reasoning domain development quotient (FQ) calculated according to Griffiths mental development scale before and after treatment.(The Griffiths Scales,The normal range is from the 16th percentile to the 84th percentile of children of the same age. 100 is the mean. The higher the score, the better)
Time frame: 104 weeks
Total T-scores and T-scores of behavior factors according to Achenbach children's behavior scale (CBCL).(The normal value is 100 points. The higher the score, the better)
Changes of total T-scores and T-scores of behavior factors calculated according to Achenbach children's behavior scale (CBCL) before and after treatment.(The normal value range is 55-70 points, and the lower the score, the better)
Time frame: 104 weeks
The adaptive behavior scale (ABAS-II) before and after treatment (GAC score) and three domain scores (cognitive skills, social skills and practical skills)
The adaptive comprehensive score was calculated according to the adaptive behavior scale (ABAS-II) before and after treatment. (The normal value is 100 points. The higher the score, the better)
Time frame: 104 weeks
height SDS
Changes of height SDS in young SGA children before and after treatment
Time frame: 104 weeks
Brain tissue metabolites
Brain tissue metabolites measured by cranial magnetic resonance spectroscopy (MRS) before and after treatment.
Time frame: 104 weeks
Myelin maturation
Myelin maturation was evaluated by diffusion tensor imaging (DTI) before and after treatment.
Time frame: 104 weeks
Brain volume and brain structure (Development)
Three dimensional T1 weighted imaging (3D) was performed before and after treatment T1WI) to assess brain volume and brain structure (Development).
Time frame: 104 weeks
Security
Related adverse reactions during the study
Time frame: 104 weeks
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