Fetomaternal Outcome Following Previous Spontaneous Abortion: An Observational Study

Spontaneous abortion (SAB, miscarriage) affects and may influence outcomes in subsequent pregnancies. This study aimed to assess maternal and fetal outcomes in women with a history of SAB who conceived a subsequent pregnancy.

A hospital‑based observational study was conducted at Mahatma Gandhi Medical College and Research Institute, Puducherry, over 18 months. Ninety‑six women aged 18-35 years with at least one previous SAB were enrolled. Maternal outcomes (gestational hypertension, diabetes mellitus, placental complications, and mode of delivery) and fetal/neonatal outcomes (fetal growth retardation, birth weight, Apgar score, and neonatal intensive care unit (NICU) admission) were recorded. Comparisons were made between single (82, 85.4%) and recurrent (≥2 abortions; 14, 14.6%) subgroups.

A total of 96 pregnant women with a history of SAB were included. The mean maternal age was 27.74 ± 4.81 years, and most participants were aged <30 years (65, 67.7%) and had conceived spontaneously (88, 91.7%). Recurrent SAB was present in 14 (14.6%) women. Gestational diabetes mellitus and gestational hypertension were observed in 17 (17.7%) and 12 (12.5%) women, respectively. Preterm delivery occurred in 12 (12.5%) pregnancies, while 58 (60.4%) women underwent cesarean section. Fetal growth restriction was identified in 12 (12.5%) cases, and NICU admission was required in 18 (18.8%) neonates. Low birth weight, low APGAR score, and meconium aspiration syndrome were each observed in 1 (1.0%) neonate, with no intrauterine deaths recorded. Recurrent abortion was associated with higher rates of preterm birth (21.4% vs. 11.0%; P = 0.375) and NICU admission (28.6% vs. 17.1%; P = 0.291), although these associations were not statistically significant. Preterm delivery was significantly associated with NICU admission (41.7% vs. 15.5%; P = 0.043).

Pregnancy after SAB generally results in favorable outcomes with no intrauterine deaths and high rates of normal birth weight and Apgar scores. However, clinically significant risks of gestational diabetes, hypertension, fetal growth retardation, high cesarean section rates, and NICU admissions persist. Structured antenatal surveillance and individualized care are recommended for this population.