Intersecting outcomes of pregnancy: a population-based analysis of abortion, miscarriage, and stillbirth among Ghanaian women of reproductive age

Background: Despite existing evidence linking abortion to subsequent reproductive complications, limited studies in Ghana have examined its relationship with miscarriage and stillbirth. This study aimed to examine the association between a history of abortion and the likelihood of miscarriage and stillbirth among Ghanaian women of reproductive age. Methods: The study analysed data from the 2017 Ghana Maternal Health Survey (GMHS), which included 24,881 women aged 15-49 years. Weighted descriptive statistics and bivariate analyses were performed to illustrate the distribution of pregnancy outcomes. Multivariable logistic regression models were fitted to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between history of abortion, miscarriage and stillbirth. A p-value <0.05 was considered statistically significant. Results: The prevalence of abortion, miscarriage, and stillbirth were 19.7%, 15.6%, and 4.8%, respectively. Further analysis revealed that women with a history of abortion were significantly more likely to experience miscarriage (aOR = 2.96; 95% CI: 2.84–3.10) and stillbirth (aOR = 1.89; 95% CI: 1.70–2.14) compared to those without a history of abortion. Conclusion: History of abortion emerged as a strong predictor of subsequent miscarriage and stillbirth among women of reproductive age. This finding emphasised that, strengthening post-abortion care, improving antenatal surveillance, and expanding access to reproductive health education are essential measures to reducing pregnancy losses and improving overall maternal outcomes.