Adverse Pregnancy Outcomes of Patients with History of Recurrent Spontaneous Abortion in the First Trimester

Background: Although a history of recurrent spontaneous abortion (RSA) in the first trimester is regarded as a risk factor in antenatal care, the characteristic of subsequent pregnancy outcome is not clearly elucidated.

Objective: To explore the relationship between RSA and maternal-placental-fetal/neonatal adverse pregnancy outcomes.

Methods: A retrospective analysis was performed on the clinical data of 492 singleton pregnant women. 164 pregnant women suffering RSA were enrolled in study group and others were in control group. Maternal-placental-fetal/neonatal adverse pregnancy outcomes in two groups were compared. The correlation between history of RSA and adverse pregnancy outcomes was analyzed by logistic regression analysis.

Results: Maternal outcomes：patients in study group delivered earlier with mean gestational age(35.76±5.20 vs 38.28±2.15 weeks, P<0.001). Rates of cesarean section and postpartum hemorrhage in study group were higher (64.02% vs 46.34%, 10.37% vs 5.49%, P<0.05). Placenta-related outcomes：rates of pregnancy complications associated with placental dysfunction such as late-onset pre-eclampsia, oligohydramnios, early-onset fetal growth restriction in study group were higher (10.37% vs 2.74%, 10.37% vs 2.13%,4.88% vs 0.61%, P<0.05). Patients in study group were more likely to suffer placenta acrreta (4.27% vs 0.61%, P<0.05). Fetal/neonatal outcomes: the risk of late abortion and the proportion of birth defects of newborns in study group were greater (9.76% vs 0.91%, 7.32% vs 0.91%, P <0.05). Neonatal birth weight of study group was lower (2676±1014 vs 3245±70g, P<0.001). Logistic regression analysis showed that a history of RSA was an independent risk factor for cesarean section and pregnancy complications such as preeclampsia, oligohydramnios, late abortion.

Conclusion: Risks of maternal-placental-fetal/neonatal adverse pregnancy outcomes increase in women with history of RSA in the first trimester and a history of RSA is significantly associated with cesarean section and pregnancy complications such as preeclampsia, oligohydramnios, late abortion.