<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 36-year-old woman, gravida 2, para 1, at 26 weeks gestation comes to the emergency department because of a gush of clear fluid from her vagina that occurred 1 hour prior. She reports painful pelvic cramping at regular 5-minute intervals. She has missed most of her prenatal care visit because of financial problems from her recent divorce. Her first child was delivered vaginally at 27 weeks gestation due to spontaneous preterm labor. She has smoked one pack of cigarettes daily for 15 years but has reduced her intake to 23 cigarettes per day since finding out she was pregnant. She continues to use cocaine once a week. Vital signs are within normal limits. Sterile speculum examination shows fluid pooling in the vagina, and nitrazine paper testing confirms the presence of amniotic fluid. Which of the following puts her at highest risk of preterm delivery?? A: Low socioeconomic status, B: Smoking during pregnancy, C: Substance abuse during pregnancy, D: Advanced maternal age, E: History of spontaneous preterm birthn,  <response>: This is a multiple choice question asking about the highest risk factor for preterm delivery in a 36-year-old pregnant woman with a history of preterm delivery, low socioeconomic status, smoking, and substance abuse during pregnancy. The key factors to consider are her previous preterm delivery at 27 weeks, ongoing substance abuse during pregnancy, and smoking during pregnancy. Her low socioeconomic status and advanced maternal age are risk factors, but not as significant as the other factors mentioned. The history of a prior preterm birth, especially at 27 weeks, is the strongest risk factor. Ongoing substance abuse and smoking during pregnancy are also major risk factors for preterm delivery.E: History of spontaneous preterm birth 