P ASTHMA

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

Tabea Brick 

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.