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Pediatr Allergy Immunol. 2019 Aug 23. doi: 10.1111/pai.13118. [Epub ahead of print]

Parents know it best: prediction of asthma and lung function by parental perception of early wheezing episodes.

Author information

1
Dr von Hauner Children's Hospital, Ludwig Maximilians University of Munich, Munich, Germany.
2
Institute for Asthma and Allergy Prevention, Helmholtz Zentrum Muenchen - German Research Center for Environmental Health, Munich, Germany.
3
Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany.
4
Christine Kühne Center for Allergy Research and Education, Davos, Schwitzerland; Children's Hospital of Eastern Switzerland, St Gallen, Schwitzerland.
5
Children's Hospital Schwarzach, Schwarzach, Austria.
6
Department of Public Health, University of Helsinki, Helsinki, Finland. P.O.Box 20, 00014 University of Helsinki, Finland.
7
Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland; P.O. Box 95, FIN-70701, Kuopio, Finland.
8
UMR/CNRS 6249 chrono-environment, University of Bourgogne Franche Comté, Besançon, France.
9
Pediatric Allergy Department, University Hospital of Nancy, Nancy, France.
10
EA3450 DevAH-Department of Physiology, Faculty of Medicine, University of Lorraine, Nancy, France.
11
Department of Respiratory Disease, University Hospital of Besançon, Besançon, France.

Abstract

BACKGROUND:

Childhood asthma is often preceded by early wheeze. Usually wheezing episodes are recorded retrospectively, which may induce recall bias.

AIMS AND OBJECTIVES:

The aim of this study was to investigate true positive recall of parent-reported wheeze at 1 year of age, its determinants and its implications for asthma and lung function at 6 years of age.

METHODS:

The PASTURE (Protection Against Allergy - Study in Rural Environment) study followed 880 children from rural areas in 5 European countries from birth up to age 6 years. Wheeze symptoms in the first year were asked weekly. At age 6 parent-reported asthma diagnosis was ascertained and lung function measurements were conducted. Correct parental recall of wheeze episodes at the end of the first year was assessed for associations with lung-function, asthma, and the asthma risk locus on chromosome 17q21.

RESULTS:

Parents correctly recalled wheeze after the first year in 54% of wheezers. This true positive recall was determined by number of episodes, timing of the last wheeze episode, and parental asthma. Independently from these determinants, true positive recall predicted asthma at age 6 years (odds ratio 4.54, 95%-confidence-interval (CI) [1.75-14.16]) and impaired lung-function (β=-0.62, 95% CI [-1.12; -0.13], p-value=0.02). Associations were stronger in children with asthma risk SNPs on chromosome 17q21.

CONCLUSION:

Correct parental recall of wheezing episodes may reflect clinical relevance of early wheeze and its impact on subsequent asthma and lung function impairment. Questions tailored to parental perception of wheezing episodes may further enhance asthma prediction. This article is protected by copyright. All rights reserved.

KEYWORDS:

asthma risk; childhood asthma; chromosome 17q21; early wheeze; genetic asthma risk; parental wheeze recall

PMID:
31441979
DOI:
10.1111/pai.13118

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