With regression logistic study, multigravida has a significantly value of the

protective factor for the PROM event with p = 0.002 (p<0.05), PR 0.035 (95%CI: 0.005–
0.266). Another study from Okeoke et al has a pretty same results with primigravida
has a higher risk for PROM especially PPROM event. The increasing in the number of
parities does not have a significantly value for higher risk PPROM. As well as the study
form Koo etl al. Primigravida is a risk factor for PROM event with p<0.001.

With regression logistic study, multigravida has a significantly value of the

protective factor for the PROM event with p = 0.002 (p<0.05), PR 0.035 (95%CI: 0.005–
0.266). Another study from Okeoke et al has a pretty same results with primigravida
has a higher risk for PROM especially PPROM event. The increasing in the number of
parities does not have a significantly value for higher risk PPROM. As well as the study
form Koo etl al. Primigravida is a risk factor for PROM event with p<0.001

In this study, we found that there was not a significant relationship between BMI
(underweight, overweight and obesity) with the PROM event on a woman of
reproductive age, (p = -,0.177,0.918). For underweight, there is no respondent were
found. The respondent with overweight BMI has the highest percentage with 80
patients (89.9%) compared with age over 35 years. The risk to experience PROM event
with BMI didn’t have a significanty value, PR 1.939 for overweight and 1.064 for
obesity. Even though, this study doesn’t know about the weight before the pregnancy,
which has to be adjusted with IOM criteria about Gestational Weight Gain (GWG) in
2009.
The study from Sung et al (2018) about the risk of spontaneous preterm birth on
a twin pregnancy according to BMI maternal showed a significant relationship between
BMI especially overweight or obesity with a preterm birth event because of PROM
(12,5%), p=0.027 and adjusted OR 1.58 (95%CI: 1.05-2.36). Otherwise on the
underweight BMI, there is the increasing of risk for preterm brith but didn’t has a
significant relationship compared to normal BMI, as well as on a respondent with
spontaneous preterm birth or because of medical indication. That things correspond
with this study which is the underweight didn’t has a significant relationship too
PROM, but not for overweight and obesity.
Obesity on pregnancy may caused an increasing of cytokine pro inflammatory
which is IL-1 and TNF- α that caused constriction of myometrium and weakening of the
membrane. Insulin resistance also play a role on preterm birth associated with CRP
and cytokine pro inflammatory (IL-1, IL-6, and TNF- α) that increased on insulin
resistance. Other than that, woman with obesity are said to have a greater risk for
urinary tract infection that lead to greater risk for chorioamnionitis then the cytokine
pro inflammatory will also increase.Underweight are said to have a greater risk of
spontaneous preterm birh (Sung et al, 2018).
A study from Parker et al (2014) has a significant results between BMI before
pregnancy and spontaneous PTB, p<0.001. Underweight 54 persons (5.8%), overweight
269 persons (28.9%), dan obesity 163 persons (17.5%). Significant results was obtained
on Gestational Weight Gain according to IOM criteria in 2009 with p<0.001 which the
weight gain during pregnancy that is not adequate was 118 persons (12,7%) and 306
persons (32,9%) for excessive weight gain. Underweight BMI has a greater risk for
spontaneous PTB but not significant about 1.46 times (95%CI: 0.99-2.16, p = 0.06). On
another hand, obesity has significant risk reduction about 0.76 times (95/5CI: 0.58-0.98,
p=0.04). When chorioamnionitis combined with BMI index, underweight has a greater
risk but not significant to late spontaenous PTB about 1,48 times (95%: 1.00-2.99,
p=0.05). On underweight that showed a greater risk for spontaneous PTB may beacause
of lack of important nutrition in pregnancy for fetal and placental growth. But on
obesity showed a risk reduction where a futher studies are needed about obesity on
inflammation marker that caused spontaenous PTB.

Sarah

Sarah

History of abortion are said to have a greater risk of PROM with mechanism of
latent local inflammation process because of abortion sugery or dilatation of cervix that
leads to cervical incompetence with risk of urinary tract infection. A study from
Moreau et al (2005) said that there is an increasing risk of severe premature birth
because of PROM on woman with history of abortion by induction.
This study showed an increasing risk of abortion towards PROM that not
significant about 1.038 times (95%CI: 0.363-2.966, p>0.05). Even so, this study is also
has a same result with the study from Makhlouf et al (2014) about pregnancy on woman
with history of abortion with or wothout induction. The results are that there are an
increasing risk of preterm PROM which is significant (p<0.05) about 2.9 times (95%CI:
1.6-5.3) on woman with history of 2 or more abortion. The greater of gestation age when
spontaneous abortion occur, will have a poor prognosis for the next pregnancy.
The study from Seol et al (2008) in Korea showed that the decreasing of
regulatory T cell which is CD4+CD25bright may caused a PROM on third trismester of
pregnancy. In this study, Hhyun-Joo also compared the group from patient with a third
trismester pregnancy that has a PROM complication with a group patient on third
trismester pregnancy without complication and labor. The study showed that
regulatory t cell were significanty decreased on a group patient with third trismester
pregnancy that has PROM complication (p<0.001) and p<0.026 when compared the
group patient on third trismester without complication with a group of patient on third
trismester with labor. The increasing of regulatory T cell on early pregnancy might be
related to implatation process period.