Dr von Hauner Children's Hospital, Ludwig Maximilians University of Munich, Munich, Germany.
Institute for Asthma and Allergy Prevention, Helmholtz Zentrum Muenchen - German Research Center for Environmental Health, Munich, Germany.
Pediatr Allergy Immunol. 2019 Dec;30(8):795-802. doi: 10.1111/pai.13118. Epub 2019 Oct 2.
Childhood asthma is often preceded by early wheeze. Usually, wheezing episodes are recorded retrospectively, which may induce recall bias.
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.
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.
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.
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.
儿童哮喘常以前期喘息为前驱。通常，喘息发作是回顾性记录的，这可能会引起回忆偏倚。
本研究旨在调查父母在 1 岁时报告喘息的真实回忆，确定其决定因素，并探讨其对 6 岁时哮喘和肺功能的影响。
PASTURE（农村环境中预防过敏的研究）研究从出生到 6 岁，在 5 个欧洲国家的农村地区跟踪了 880 名儿童。在第一年中每周询问喘息症状。在 6 岁时，确定了父母报告的哮喘诊断，并进行了肺功能测量。评估父母在第一年结束时对喘息发作的正确回忆与肺功能、哮喘和染色体 17q21 上的哮喘风险基因座之间的关联。
在 54%的喘息患儿中，父母正确回忆了第一年之后的喘息。这种真实回忆由发作次数、最后一次喘息发作的时间和父母的哮喘决定。独立于这些决定因素，真实回忆预测了 6 岁时的哮喘（比值比 4.54，95%置信区间[1.75-14.16]）和肺功能受损（β= -0.62，95%置信区间[-1.12；-0.13]，P 值=.02）。在染色体 17q21 上具有哮喘风险 SNP 的儿童中，关联更强。
父母对喘息发作的正确回忆可能反映了早期喘息的临床相关性及其对随后哮喘和肺功能损害的影响。针对父母对喘息发作的感知量身定制的问题可能会进一步提高哮喘预测的准确性。
