Abstract: OBJECTIVE To analyze the gene polymorphism of nuclear transcription factor-κB (NF-κB), the distribution of pathogenic bacteria and drug resistance in patients with premature rupture of fetal membrane complicated with chorioamnitis. METHODS From Jul 2021 to Jun 2022, 60 patients with premature rupture of membranes combined with chorioamnitis admitted to Huai'an Maternal and Child Health Hospital Affiliated to Yangzhou University were included in the study group, and 73 patients with premature rupture of membranes without chorioamnitis were included in the control group. Clinical data of patients were retrospectively collected. Clinical data, polymorphism of NF-κB gene, distribution of pathogenic bacteria and drug resistance of main pathogenic bacteria were analyzed. RESULTS There was no significant difference in age, pre-pregnancy body mass index (BMI), gestational age, gestational number, birth number and newborn sex between the two groups. Compared with the control group, the proportion of genotypes of DD and D allele in NF-κB-94ins/delATTG promotor in the study group was higher, and genotype of II were lower (P＜0.05). A total of 66 strains of pathogenic bacteria were isolated from 60 patients with premature rupture of membranes complicated with chorioamnitis, among which gram-negative bacteria accounted for 72.73% (mainly Escherichia coli) and gram-positive bacteria accounted for 27.27% (mainly Enterococcus faecalis). The drug resistance rates of E. coli to imipenem and amikacin were low (<5.00%), while those of E. coli to piperacillin and erythromycin were high (>70.00%). There were no strains were detected drug resistant to linezolid, gentamicin and teicolanin in 10 E. faecalis strains and nine erythromycin-resistant and eight clindamycin-resistant strains were detected. CONCLUSION Premature rupture of membranes complicated with chorioamnitis might be related to the polymorphism of NF-κB gene. gram-negative bacteria were mainly E. coli, and gram-positive bacteria were mainly E. faecalis. In clinical practice, pathogenic bacteria should be detected by timely sampling of fetal membranes. And antibiotics should be selected reasonably according to the results of drug sensitivity.