Early rattles, purrs and whistles as predictors of later wheeze

• Published in: Archives of disease in childhood 2008-08, Vol.93 (8), p.701-704
• Main Authors: Turner, S W, Craig, L C A, Harbour, P J, Forbes, S H, McNeill, G, Seaton, A, Devereux, G, Russell, G, Helms, P J
• Format: Article
• Language: English
• Subjects: Age; Asthma; Asthma - diagnosis; Asthma in children; Biological and medical sciences; Care and treatment; Child, Preschool; Childhood asthma; Children & youth; Chronic obstructive pulmonary disease, asthma; Epidemiology; Female; General aspects; Humans; Institutional Research; Longitudinal Studies; Male; Medical sciences; Miscellaneous; Mothers; Noise; Parents; Parents & parenting; Patient outcomes; Pneumology; Predictive Value of Tests; Pregnancy; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Respiratory organs; Respiratory sounds; Respiratory Sounds - etiology; Risk factors; Sound; Sounds; Statistical Analysis; Studies; Surveys and Questionnaires; Tobacco Smoke Pollution - adverse effects; Young Children
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2007.134569

Background:Asthma is a common condition characterised by wheeze. Many different respiratory sounds are interpreted by parents as “wheeze” in young children.Aim:To relate different respiratory sounds reported as wheeze in 2-year-olds to asthma outcomes at age 5 years.Methods:As part of a longitudinal cohort study, parents completed respiratory questionnaires for their children at 2 and 5 years of age. Parents who reported wheeze were given options to describe the sound as rattling, purring or whistling.Results:Of the 1371 2-year-olds surveyed, 210 had current wheeze, of whom 124 had rattle, 49 purr and 24 whistle. Children with whistle at 2 years were more likely to have mothers with asthma, and children with rattle and purr were more likely to be exposed to tobacco smoke. Wheeze status was ascertained at age 5 years in 162 (77%) children with wheeze at 2 years of age. Whistle persisted in 47% of affected children, rattle in 20%, and purr in 13% (p = 0.023). At 5 years of age, asthma medication was prescribed in 40% with whistle, 11% with rattle, and 18% with purr at 2 years of age (p = 0.017).Conclusions:This study shows different risk factors and outcomes for different respiratory sounds in 2-year-olds: compared with other respiratory sounds, whistle is likely to persist and require asthma treatment in future.