PRENATAL AND PERINATAL RISK-FACTORS FOR ASTHMA IN INNER-CITY AFRICAN-AMERICAN CHILDREN

The relations between pre- and perinatal risk factors and asthma were investigated using a case-control study of 262 African-American childr en aged 4-9 years, both asthmatic and nonasthmatic, all of whom reside d in a poor urban area and received health care at a local hospital-ba sed clinic, Risk factors were ascertained through review of obstetric, perinatal, and pediatric records, Asthmatic children had significantl y lower birth weights and gestational ages than nonasthmatic children and were more likely to have required oxygen supplementation and posit ive pressure ventilation after birth than nonasthmatics (p < 0.05). Th e mothers of asthmatic children were more likely to have smoked during pregnancy (50% vs. 27%), to have gained less weight during pregnancy (26.3 pounds (11.9 kg) vs. 34.5 pounds (15.7 kg)), and to have had no prenatal care (12% vs. 2%) than mothers of nonasthmatic children, Mult iple logistic regression demonstrated that the strongest independent p redictors of asthma were maternal history of asthma (adjusted odds rat io (OR) = 9.7), lack of prenatal care (OR = 4.7), history of bronchiol itis (OR = 4.7), positive pressure ventilation at birth (OR = 3.3), lo w maternal weight gain (<20 pounds (<9 kg)) (OR = 3.4), and maternal s moking during pregnancy (OR = 2.8), These data suggest that pre- and p erinatal exposures may increase susceptibility to asthma in inner city children.