American Journal of Epidemiology Vol. 142, No. 10: 1078-1088
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health
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Maternal Asthma and Idiopathic Preterm Labor
1Department of Pediatrics, McGill University Faculty of Medicine Montreal, Quebec, Canada
2Department of Obstetrics and Gynecotogy, McGill University Faculty of Medicine Montreal, Quebec, Canada
3Department of Epidemiology and Biostatistlcs, McGill University Faculty of Medicine Montreal, Quebec, Canada
4Département de Médecine, Université de Montréal Montreal, Quebec, Canada
Previous studies suggest that women with asthma are at increased risk of preterm birth. Moreover, drugs (especially ß-agonists) used to treat asthma are also used to treat preterm labor. The authors carried out a case-control study of 555 women from three hospital centers with idiopathic preterm labor (<37 weeks), including two overlapping (i.e., non-mutually exclusive) subsamples: cases with early idiopathic preterm labor (<34 weeks) and cases with idiopathic recurrent preterm labor (<37 weeks plus a previous history of preterm delivery or second-trimester miscarriage). Controls were matched to cases according to race and smoking history prior to and during pregnancy. All subjects responded in person to questions about atopic, respiratory, obstetric, and sociodemographic histories. Subjects in the early and recurrent preterm labor subsamples were also asked to undergo spirometric testing with methacholine challenge 6–12 weeks after delivery. Cases were significantly more likely to report histories of asthma symptoms and physician-diagnosed asthma (matched odds ratios of 2–3) than controls, particularly those cases with recurrent preterm labor. No significant associations were observed, however, with methachoiine responsiveness. These results could not be explained by residual confounding by smoking or other variables, nor by selective recall of asthma symptoms and histories by cases. Women with asthma are at increased risk of idiopathic preterm labor. The fact that no such association was seen with methachoiine responsiveness suggests that nonatopic, noncholinergic mechanisms may link bronchial and uterine smooth muscle lability. Am J Epidemiol 1995;142:1078–88.
asthma; Infant; low birth weight; infant; premature; labor; premature
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