OBJECTIVE: Patients with recurrent first-trimester spontaneous abortion have been the subject of intensive investigation. However, relatively little is known about second-and third-trimester pregnancy loss. Thus, it is difficult for cl inicians to optimally counsel, evaluate, and manage women with previous unexplai ned fetal death. Our objective was to ascertain the outcome of subsequent pregna ncies in patients with prior fetal death. METHODS: Subjects were identified from patients referred for evaluation of fetal death (occurring at ≥10 weeks of ges tation) and having at least one subsequent pregnancy. Patients with antiphosphol ipid antibodies were excluded. Logistic regression analysis was performed to det ermine the association of clinical variables with pregnancy outcome. RESULTS: Tw o hundred thirty subjects met inclusion criteria. Up through the time of their f irst fetal death, these women had a total of 721 pregnancies, resulting in 268 ( 37%) live births, 230 (32%) fetal deaths, and 200 (28%) spontaneous abortions . In total, these women had 839 subsequent pregnancies, resulting in 202 (24%) live births, 209 (25%) fetal deaths, and 372 (44%)spontaneous abortions. Univa riate logistic regression analysis identified older age at pregnancy (P = .009, odds ratio 0.63, 95%confidence interval 0.42-1.03) and treatment with lowdose aspirin (P = .001, odds ratio 0.41, 95%confidence interval 0.25-0.68) to be as sociated with a decreased risk for subsequent pregnancy loss. CONCLUSION: Women with prior fetal death are at high risk for subsequent pregnancy loss and recurr ent fetal death, with fewer than 25%of pregnancies resulting in surviving infan ts. These data underscore the need for additional research into the pathophysiol ogy and prevention of recurrent fetal death. OBJECTIVE: Patients with recurrent first-trimester spontaneous abortion have been the subject of intensive investigation. However, relatively little is known about second-and third-trimester pregnancy loss. Thus, it is difficult for cl inicians to optimally counsel, evaluate, and manage women with previous unexplai ned fetal death. Our objective was to ascertain the outcome of subsequent pregna ncies in patients with prior fetal death. METHODS: Subjects were identified from patients referred for evaluating of fetal death (occurring at ≧ 10 weeks of gestion) and Patients with antiphosphol ipid antibodies were excluded. Logistic regression analysis was performed to det ermine the association of clinical variables with pregnancy outcome. RESULTS: Tw o hundred thirty subjects met inclusion criteria. Up through the time of their f irst fetal death, these women had a total of 721 pregnancies, resulting in 268 (37%) live births, 230 (32%) fetal d In total, these women had 839 subsequent pregnancies, resulting in 202 (24%) live births, 209 (25%) fetal deaths, and 372 (44%) spontaneous abortions. logistic regression analysis identified older at at pregnancy (P = .009, odds ratio 0.63, 95% confidence interval 0.42-1.03) and treatment with lowdose aspirin (P = .001, odds ratio 0.41, 95% confidence interval 0.25-0.68) to CONCLUSION: Women with prior fetal death are at high risk for subsequent pregnancy loss and recurr fetal death, with fewer than 25% of pregnancies resulting in surviving infan ts. These data underscore the need for additional research into the pathophysiology and prevention of recurrent fetal death.