High Apoptotic Index in Amniotic Membrane of Pregnant Women is A Risk Factor for Preterm Labor

Abstract

This study aims to prove a high apoptotic index in the amniotic membrane as a risk factor for preterm Labor. Case-control study, comparing preterm and term groups (n=54) who underwent labor in Obstetrics Emergency Room, Sanglah Central General Hospital Denpasar, Bali. Apoptotic index is a method of identifying and assessing the quantity of tissue undergoing apoptosis, which in this study was the amniotic membrane tissue, calculated and stained using the TUNEL method. Data collected was subjected to further statistical tests. Normality test with Shapiro Wilk test, followed by parametric independent T-test and Mann Whitney test was performed. Cut off apoptotic index was determined using the Receiver Operating Characteristic (ROC) curve. Bivariate analysis with Chi-square test and calculation of odds ratio was performed to assess the high apoptotic index to the risk of preterm Labor. Statistical significance was obtained with p value <0.05. Based on the cut-off value of ROC, the apoptotic index was classified into high (≥37.5%) and low (<37.5%) apoptotic index. A high apoptotic index is a risk factor for preterm Labor and increases the risk 6 times greater than the group with a low apoptotic index (p=0.003; OR 5.714; 95% CI 1.764–18.507). High apoptotic index in the amniotic membranes of pregnant women is a risk factor for preterm Labor.