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The prevalence and natural history of wheezing in early childhood
Insights
Early onset of childhood wheeze generally indicates a better prognosis for respiratory illness. Parental recall of early wheezing symptoms is often incomplete, potentially skewing prevalence data.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Epidemiology
Background:
- Wheezing is a common symptom in early childhood.
- Understanding the long-term implications and accurate prevalence of childhood wheeze is crucial for effective management.
Purpose of the Study:
- To investigate the prognosis of childhood wheeze based on age of onset.
- To compare the accuracy of parental recall versus general practice records for identifying early wheezing episodes.
Main Methods:
- Retrospective review of general practice records for 369 children at age seven.
- Comparison of parental questionnaire data with medical records for 174 children.
Main Results:
- 31% of children had a record of wheeze, with over half presenting before age three.
- Earlier onset of wheeze correlated with a better prognosis for wheezing or lower respiratory tract illness at ages five to seven.
- Parental recall of early wheeze was incomplete and biased by symptom severity and persistence.
Conclusions:
- The age of onset is a significant factor in the prognosis of childhood wheeze.
- Parental questionnaires may underestimate wheeze prevalence in infancy and overestimate persistent wheezing in later childhood due to recall bias.
Abstract:
The general practice records of 437 children were reviewed at seven years of age. Of 369 children with complete records, 115 (31 per cent) had some record of wheeze. Over half of these had first presented before the age of three years. In terms of consultations for wheezing or lower respiratory tract illness at the ages of five to seven years, the earlier the onset of wheeze the better the prognosis.Comparison of data from parental questionnaires with the general practice records of 174 children suggested that parental recall of early episodes of wheeze is incomplete and biassed by the severity and persistence of the symptoms of the child. Questionnaire surveys may therefore have excluded many mild cases of wheezing in early childhood, thus underestimating the prevalance of wheezing in infancy, and overestimating the proportion of such cases who progress to persistent wheezing in later childhood.
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