- Objective The objective of the study was to determine whether 1 previous miscarriage is associated with an increased rate of adverse pregnancy outcomes in the following pregnancy. Study Design Second pregnancies of women with and without a miscarriage in their initial pregnancy were compared. Multivariable logistic regression models were constructed to control for confounders. Results Of 35,125 singleton deliveries in the second pregnancy, 5777 (16.4%) were of patients with an initial miscarriage. Multivariable analysis showed a significant association between a previous miscarriage and the following adverse pregnancy outcomes including premature rupture of membranes (odds ratio [OR], 2.22; 95% confidence interval [CI], 2.01–2.44), preterm delivery (OR, 1.34; 95% CI, 1.21–1.48), intrauterine growth restriction (OR, 1.24; 95% CI, 1.04–1.47), hypertensive disorders (OR 1.41; 95% CI 1.07–1.85), preeclampsia (OR, 1.63; 95% CI, 1.22–2.18), and cesarean delivery (OR, 1.59; 95% CI, 1.46–1.73). Perinatal mortality was significantly higher among women with an initial miscarriage (1.6% vs 1.0%; P Conclusion An initial miscarriage is independently associated with adverse pregnancy outcomes.