A Literature Review Overview of Factors Influencing the Incidence of Abortion

Authors

  • Endah Endah Polytechnic of Health Jakarta III
  • Aticeh Aticeh Polytechnic of Health Jakarta III
  • Rosita Rosita Polytechnic of Health Jakarta III
  • Debbiyantina Debbiyantina Polytechnic of Health Jakarta III

DOI:

https://doi.org/10.70062/globalhealth.v2i4.250

Keywords:

Literature Review, Pregnancy, Reproductive Health, Risk Factors, Social Determinants

Abstract

Abortion remains a complex reproductive health issue due to the interplay of multiple interrelated determinants. This study aimed to map the factors influencing the incidence of abortion based on recent scientific evidence. A literature review design was applied by analyzing ten selected articles published within the last five years and retrieved from major scientific databases. The selection process was conducted systematically through title, abstract, and full-text screening based on predefined inclusion criteria. The extracted data included study characteristics, type of abortion, examined determinants, and key conclusions. The synthesized findings indicate that abortion incidence is shaped by a combination of biological, social, and healthcare system related factors. Clinical determinants such as maternal age, endocrine disorders, uterine anatomical abnormalities, obstetric history, anemia, and hypertension play a substantial role in spontaneous and recurrent miscarriage. In contrast, structural factors including income level, contraceptive access, and legal regulations predominantly influence induced abortion. The discussion highlights that abortion should not be viewed as an isolated clinical event, but rather as the cumulative outcome of risks operating across multiple levels of influence. In conclusion, abortion represents a multifactorial phenomenon that requires comprehensive prevention strategies extending beyond medical interventions alone. These strategies should also address healthcare accessibility and broader social conditions. This review contributes to a deeper understanding of the complexity of abortion determinants and provides an evidence-based reference for developing more effective preventive approaches in the future.

References

Bearak, J., Popinchalk, A., Ganatra, B., Moller, A.-B., Tunçalp, Ö., Beavin, C., Kwok, L., & Alkema, L. (2020). Unintended pregnancy and abortion by income, region, and the legal status of abortion: Estimates from a comprehensive model for 1990–2019. Lancet Global Health, 8(9), e1152–e1161. https://doi.org/10.1016/S2214-109X(20)30315-6

Carbonnel, M., Pirtea, P., De Ziegler, D., Ayoubi, J. M., & Ph, D. (2021). Uterine factors in recurrent pregnancy losses. Fertility and Sterility, 115(3), 538–545. https://doi.org/10.1016/j.fertnstert.2020.12.003

Carvajal, B., White, H., Brooks, J., Thomson, A. M., & Cooke, A. (2022). Experiences of midwives and nurses when implementing abortion policies: A systematic integrative review. Midwifery, 111, 103363. https://doi.org/10.1016/j.midw.2022.103363

Chae, S., Desai, S., Crowell, M., Sedgh, G., & Singh, S. (2017). Characteristics of women obtaining induced abortions in selected low- and middle-income countries. PLoS One, 12(3), 1–19. https://doi.org/10.1371/journal.pone.0172976

Chrysanthopoulos, I., Potiris, A., Drakaki, E., Mavrogianni, D., Machairiotis, N., Zarogoulidis, P., Karampitsakos, T., et al. (2023). Association between COVID-19 infection and miscarriages: What we really know? Diseases, 11(173). https://doi.org/10.3390/diseases11040173

Desai, S., Lindberg, L. D., Maddow, I., & Zimet, K. (2021). The impact of abortion underreporting on pregnancy data and related research. Maternal and Child Health Journal, 25(8), 1187–1192. https://doi.org/10.1007/s10995-021-03157-9

Dewidar, O., John, J., Saad, A., Riddle, A., Ota, E., Kung, J. K., Arabi, M., et al. (2024). Effectiveness of nutrition counseling for pregnant women in low- and middle-income countries to improve maternal and infant behavioral, nutritional, and health outcomes: A systematic review. Maternal & Child Nutrition, 19(e1361). https://doi.org/10.1002/cl2.1361

Flannery, C., Hennessy, M., Dennehy, R., Matvienko Sikar, K., & Lucey, C. (2023). Factors that shape recurrent miscarriage care experiences: Findings from a national survey. BMC Health Services Research, 23(317), 1–10. https://doi.org/10.1186/s12913-023-09347-1

Ganatra, B., Gerdts, C., Rossier, C., Ronald, B., Johnson Jr., J., Tunçalp, Ö., Assifi, A., Sedgh, G., & Singh, S. (2017). Global, regional, and subregional classification of abortions by safety, 2010–2014: Estimates from a Bayesian hierarchical model. The Lancet, 390(2372), 81. https://doi.org/10.1016/S0140-6736(17)31794-4

Kalla, A., Loucif, L., & Yahia, M. (2022). Miscarriage risk factors for pregnant women: A cohort study in Eastern Algeria’s population. The Journal of Obstetrics and Gynecology of India, 72(s1), 109–120. https://doi.org/10.1007/s13224-021-01564-0

Keogh, S. C., Otupiri, E., Chiu, D. W., Polis, C. B., Hussain, R., Bell, S. O., Nakua, E. K., & Larsen-Reindorf, R. (2020). Estimating the incidence of abortion: A comparison of five approaches in Ghana. BMJ Global Health, 5(4), 1–10. https://doi.org/10.1136/bmjgh-2019-002129

Magnus, M. C., Wilcox, A. J., Morken, N.-H., Weinberg, C. R., & Håberg, S. E. (2019). Role of maternal age and pregnancy history in risk of miscarriage: Prospective register based study. BMJ, 364, l869. https://doi.org/10.1136/bmj.l869

Makleff, S., Belfrage, M., Wickramasinghe, S., Fisher, J., Bateson, D., & Black, K. I. (2023). Typologies of interactions between abortion seekers and healthcare workers in Australia: A qualitative study exploring the impact of stigma on quality of care. BMC Pregnancy and Childbirth, 23(646), 1–14. https://doi.org/10.1186/s12884-023-05902-0

Quenby, S., Gallos, R. K., Dhillon-Smith, I. D., Podesek, M., Stephenson, M. D., Fisher, J., Brosens, J. J., Brewin, J., Ramhorst, R., Lucas, E. S., McCoy, R. C., Anderson, R., Daher, S., Regan, L., Al-Memar, M., Bourne, T., MacIntyre, D. A., Rai, R., Christiansen, O. B., Sugiura-Ogasawara, M., Odendaal, J., Devall, A. J., Bennett, P. R. (2021). Miscarriage matters: The epidemiological, physical, psychological, and economic costs of early pregnancy loss. The Lancet, 397(10285), 1252981. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1252981

Saraswati, P. W. (2019). Saving more lives on time: Strategic policy implementation and financial inclusion for safe abortion in Indonesia during COVID-19 and beyond. Frontiers in Global Women’s Health, 3, 901842. https://doi.org/10.3389/fgwh.2022.901842

Sofia, N., Fadlyana, E., Irianti, S., Krisnadi, S., & Susiarno, H. (2024). Maternal risk factors among pregnant women with miscarriage. Althea Medical Journal, 11(1), 57–62. https://doi.org/10.15850/amj.v11n1.3037

Sun, H., Mao, J., Su, X., & Du, Q. (2023). Impact of spontaneous abortion history and induced abortion history on perinatal outcomes of singleton pregnancies. BMC Public Health, 23(2360), 1–10. https://doi.org/10.1186/s12889-023-17264-5

Tan, Y., Li, S., Xu, H., & Wang, S. (2024). High-risk factors for massive hemorrhage in medical abortion patients with missed miscarriage. BMC Pregnancy and Childbirth, 24(521), 1–10. https://doi.org/10.1186/s12884-024-06682-x

Turesheva, A., Aimagambetova, G., Ukybassova, T., Marat, A., Kanabekova, P., Almawi, W. Y., & Kaldygulova, L., Ilmaliyeva, A., Ryzhkova, S., Nogay, A., Khamidullina, Z., Ilmaliyeva, A., & Kaldygulova, L. (2023). Recurrent pregnancy loss etiology, risk factors, diagnosis, and management. Clinical Medicine, 12(4074), 1–26. https://doi.org/10.3390/jcm12124074

Wang, M., Yang, X., Li, L., Zhu, H., Zhang, H., Jiang, Y., & Liu, R. (2022). Incidence and risk factors for early pregnancy loss in women with first pregnancy undergoing in vitro fertilization-embryo transfer. BMC Pregnancy and Childbirth, 22(575), 1–7. https://doi.org/10.1186/s12884-022-04904-8

WHO. (2022). Abortion care guideline. World Health Organization.

Downloads

Published

2025-12-29

How to Cite

Endah, E., Aticeh, A., Rosita, R., & Debbiyantina, D. (2025). A Literature Review Overview of Factors Influencing the Incidence of Abortion. Global Health: Journal of Health Sciences, Public Health and Pharmacy, 2(4), 11–19. https://doi.org/10.70062/globalhealth.v2i4.250