Objective To analyze the current status of recurrent abortion and contraceptive condition among nulliparous adolescent females.

Methods Data on abortion and contraception were collected from nulliparous adolescent females aged 15 to 24 years who had at least one history of induced or medical abortion and still requested induced or medical abortion for the current pregnancy between July 2019 and June 2024. The influencing factors of recurrent abortion were analyzed.

Results The study included 3, 081 cases of non-recurrent abortion (including 1, 983 induced abortions, 1, 098 medical abortions) and 804 cases of recurrent abortion (including 475 induced abortions, 329 medical abortions) among nulliparous adolescent females. Statistically significant differences were observed between recurrent and non-recurrent abortion groups in terms of age composition, marital status, household registration, and educational level (P < 0.05). Logistic regression analysis revealed that nulliparous adolescent females aged ≤19 years (OR=1.21, 95%CI, 0.93 to 1.73), with high school education or below (OR=2.13, 95%CI, 1.77 to 2.82), unmarried (OR=1.92, 95%CI, 1.25 to 2.64), and non-local household registration (OR=2.68, 95%CI, 2.19 to 3.63) had an increased risk of recurrent abortion. Among nulliparous adolescent females, the proportion of those who did not use contraception was 62.8% (505/804) among those with a history of repeated abortions, which was significantly higher than that among those without a history of repeated abortions 28.1%(865/3, 081), P < 0.001. Although there was no statistically significant difference in the proportion of those using specific contraceptive methods between the two groups (P>0.05), the proportion of those using contraception among those with a history of repeated abortions was 37.2%(299/804), which was significantly lower than that among those without a history of repeated abortions 71.9%(2, 216/3, 081), P < 0.001. Only 0.3% of those with a history of repeated abortions used intrauterine devices as a contraceptive method.

Conclusion Young age, low educational level, being unmarried, and non-local household registration are high-risk factors for recurrent abortion among nulliparous adolescent females. Failure to use contraception or use of ineffective contraceptive methods is the main reason for recurrent induced abortion. Strengthening post-abortion care by medical staff and promoting contraceptive knowledge education and efficient contraceptive methods among adolescent females are of great significance in reducing the rate of recurrent induced abortion.