Relationship between spontaneous abortion history and treatment outcomes in patients with threatened abortion: a prospective cohort study
Grudnitskaya E.N.
Objective: Identification of relationship between the history of spontaneous abortion (SA) and miscarriage in patients with singleton pregnancy associated with threatened miscarriage (TM) in singleton pregnancy.
Materials and methods: A prospective cohort study was carried out among the patients who were admitted to hospital and underwent treatment due to TM in 2021. The patients were divided into two groups. The exposed group included 97 women with spontaneous abortion history, and the unexposed group comprised 145 women without SA history. Both groups were divided into the subgroups based on the obstetric outcomes – prolongation of pregnancy or SA. The relationship between SA history and miscarriage in cases of threatened abortion, as well as the differences between the clinical and laboratory parameters on the first day of hospitalization due to TM in patients with and without SA history were identified based on the results of comprehensive physical exam.
Results: The women with TM and singleton pregnancy, who had SA history, relative risk of adverse pregnancy outcome, particularly termination of pregnancy was 3.3 (95% CI 1.2–9.2), р=0.018, that contributed to the increased number of cases of habitual abortion (HA). The incidence rate of SA in the cohort was 6.6%. All patients with TM (in the exposed and unexposed groups) had latent iron deficiency characterized by the median ferritin level below 30 μg/L. Double increase in the frequency of hypothyroidism detection in patients with previous SA (OR 2.0; 95% CI 0.9–4.3; p=0.073) did not reach statistical significance of the obtained results.
Conclusion: Given that in pregnant women with the diagnosis of threatened miscarriage, who previously experienced SA, relative risk of recurrent miscarriage is 3.3-fold higher, that can lead to habitual abortion, it is necessary that the patients with the burdened anamnesis should be carefully monitored. Particularly, it is necessary to develop and closely monitor management strategy for these women during the pregravid preparation, that is highly important for reducing the risk.
Conflicts of interest: The author has no conflict of interest to declare.
Funding: The study was carried within the State program of scientific researches of the Republic of Belarus “Translational medicine”, assignment No. 3.47 «To develop the method of preventive healthcare for spontaneous abortions and preterm births in pregnant women with connective tissue dysplasia”, state registration No. 20220318, implementation term 01.01.2022–31.12.2024.
Gratitude: The author of the article expresses gratitude to S.L. Voskresensky, Professor, MD, for consultations in planning this study.
Ethical Approval: The study was approved by the Ethics Committee of Belarusian Medical Academy of Postgraduate Education" (Protocol No. 1 of February 06, 2020).
Patient Consent for Publication: The patients have signed informed consent for publication of the obtained data.
Author's Data Sharing Statement: The data supporting the findings of this study are available on request from the author.
For citation: Grudnitskaya E.N. Relationship between spontaneous abortion history and
treatment outcomes in patients with threatened abortion: a prospective cohort study.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (11): 77-85 (in Russian)
https://dx.doi.org/10.18565/aig.2025.203
Keywords
threatened miscarriage
spontaneous abortion
recurrent miscarriage
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Received 28.07.2025
Accepted 05.11.2025
About the Authors
Elena N. Grudnitskaya, PhD, Associate Professor, Associate Professor of the Department of Obstetrics and Gynecology, Institute of Advanced Training and Retraining of Healthcare Personnel, Belarusian State Medical University, 220013, Republic of Belarus, Minsk, P. Brovki str., 3, bldg. 3, +37529560-53-61, grudnickaja@mail.ru,https://orcid.org/0009-0003-5268-4029
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