Abstract
BACKGROUND: This study aims develop and validate a prediction model for estimating the individual risk of histological chorioamnionitis (CA) in women presenting with preterm premature rupture of membranes (pPROM), based on readily available antepartum laboratory indicators. METHODS: The clinical data of 118 patients with pPROM and 93 pregnant women with unruptured membranes matched by gestational weeks were collected. According to the diagnostic criteria of histological CA, patients with pPROM were divided into 65 cases of pPROM-non CA group and 53 cases of pPROM-CA group. The differences in laboratory indicators such as microRNA-199a-5p (miR-199a-5p) and white blood cells (WBC) among different groups were compared. The correlation between miR-199a-5p and laboratory indicators was evaluated using the Pearson method. Logistic regression analysis of the risk factors of pPROM-CA. Receiver operator characteristic (Fecho et al. Ther Clin Risk Manag 4:681-688, 2008) ( curves were established to evaluate the predictive meaning of miR-199a-5p for pPROM-CA. RESULTS: The expression of miR-199a-5p increased in the pPROM group, and the increase amplitude in the pPROM-CA group was significantly higher than that in the pPROM-non CA group. Logistic regression analysis revealed that C-reactive protein (CRP), Heparin-binding protein (HBP) and miR-199a-5p were independent risk factors for the occurrence of pPROM-CA. ROC analysis demonstrated that the combined prediction of CRP, HBP and miR-199a-5p had the highest area under the curve (AUC) value, and its predictive value was higher than that of a single indicator. CONCLUSIONS: The combination of miR-199a-5p, CRP and HBP can effectively stratify the risk of pPROM-CA in patients with pPROM, providing a basis for early clinical triage and management decisions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-026-08896-7.