The impact of preschool wheezing patterns on health-related quality of life at age 4 years.

We assessed whether dynamic preschool wheezing patterns affect health-related quality of life (HRQOL) at age 4 years. The study included 3878 children participating a prospective cohort study. Information on preschool wheezing was obtained by questionnaire and children were categorised into: never, early, late and persistent wheezing. At age 4 years HRQOL was measured using the Child Health Questionnaire (CHQ). Persistent wheezing was associated with reduced scores for nine out of 13 CHQ scales. No differences in psychosocial CHQ scores (p>0.05), but lower physical CHQ scores were found in children with late and persistent wheezing, compared to children who never wheezed (p<0.001). Mean scores on general health perceptions were, respectively, eight and 12 points lower (on a 0-100 scale) in children with late and persistent wheezing (p<0.001), and children with one to three episodes and four or more episodes of wheezing in the fourth year respectively scored seven and 24 points lower (p<0.001), compared to children who never wheezed. Persistent wheezing during preschool age independently affects a child's HRQOL, particularly general health perceptions and physical domains at age 4 years. HRQOL was more affected by frequent wheezing episodes in the fourth year of life, rather than by the duration of wheezing at age 0-4 years.