Parents know it best: Prediction of asthma and lung function by parental perception of early wheezing episodes.
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 Environments) study followed 880 children from rural areas in 5 European countries from birth 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 = .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.
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D001249:Asthma D002648:Child D002675:Child, Preschool D015331:Cohort Studies D005060:Europe D005260:Female D005500:Follow-Up Studies D006801:Humans D007223:Infant D007231:Infant, Newborn D008297:Male D010290:Parents D010465:Perception D015995:Prevalence D011379:Prognosis D011446:Prospective Studies D012135:Respiratory Sounds D012189:Retrospective Studies D012424:Rural Population D011795:Surveys and Questionnaires
early wheeze childhood asthma asthma risk chromosome 17q21 genetic asthma risk parental wheeze recall