MATERNAL ASTHMA AND IDIOPATHIC PRETERM LABOR

Previous studies suggest that women with asthma are at increased risk of preterm birth, Moreover, drugs (especially P-agonists) used to trea t asthma are also used to treat preterm labor. The authors carried out a case-control study of 555 women from three hospital centers with id iopathic preterm labor (<37 weeks), including two overlapping (i.e., n on-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-trimes ter 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 soci odemographic histories, Subjects in the early and recurrent preterm la bor subsamples were also asked to undergo spirometric testing with met hacholine challenge 6-12 weeks after delivery. Cases were significantl y more likely to report histories of asthma symptoms and physician-dia gnosed asthma (matched odds ratios of 2-3) than controls, particularly those cases with recurrent preterm labor. No significant associations were observed, however, with methacholine responsiveness, These resul ts 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 methacholine re sponsiveness suggests that nonatopic, noncholinergic mechanisms may li nk bronchial and uterine smooth muscle lability.