Objective:
To assess whether adenotonsillectomy (AT) is associated with undesirable weight gain in children with mild obstructive sleep-disordered breathing (oSDB).
Approach:
- Study Design: Exploratory analysis of the Pediatric Adenotonsillectomy Trial for Snoring randomized clinical trial.
- Participants: 375 children aged 3 to 12 years, average age 6.1 years, 50.2% female, across seven U.S. pediatric tertiary care centers.
- Definitions: Mild oSDB defined as snoring with an obstructive apnea-hypopnea index (oAHI) of <3 events/hour.
- Interventions: Comparison of early adenotonsillectomy (eAT) with watchful waiting and supportive care (WWSC) over 12 months.
- Primary Outcome: 12-month change in the percentage of the 95th BMI percentile (%BMIp95).
Key Findings:
- No significant difference in undesirable weight gain between eAT (32%) and WWSC (27%) groups.
- Children in the eAT group had a 1.25-point increase in %BMIp95 compared to a 0.59-point increase in the WWSC group.
- Regression analysis showed early adenotonsillectomy was associated with a 0.84-point higher %BMIp95 at 12 months, but not statistically significant.
- A significant association was found between higher oAHI and undesirable weight gain, regardless of treatment group.
Interpretation:
Limitations:
- Generalizability limited to elementary school-aged children with mild oSDB.
- Findings may not apply to adolescents or those with severe OSA or severe obesity.
Conclusion:
The study suggests that adenotonsillectomy does not significantly contribute to undesirable weight gain in children with mild obstructive sleep-disordered breathing.
Sources:
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