Gestational diabetes mellitus (GDM) is a common metabolic disease in pregnant women. The purpose of this study was to determine whether a history of abortion increases the risk of GDM by meta-analysis.

A comprehensive literature search was conducted in nine databases of studies on the association between abortion history and GDM up to April 12, 2022. Fixed- or random-effects models were used to estimate the pooled odds ratio (OR) and 95% CI. The I square value (I²) was used to assess heterogeneity. Possible sources of heterogeneity were explored by conducting subgroup analysis and meta-regression. A sensitivity analysis was also performed for this meta-analysis. Publication bias was assessed by funnel plots and Egger’s tests.

Thirty-one studies enrolling 311,900 subjects were included in this meta-analysis. The risk of GDM was higher in women who experienced abortion than in those who did not (OR = 1.41 95% CI: 1.28–1.55, I² = 66.8%). The risk of GDM increased with an increasing number of abortions (1 time: OR = 1.67, 95% CI = 1.26–2.22; 2 times: OR = 2.10, 95% CI = 1.26–3.49; ≥3 times: OR = 2.49, 95% CI = 1.24–5.01). Both spontaneous abortion (OR = 1.52, 95% CI = 1.30–1.78) and induced abortion (OR = 1.07, 95% CI = 1.03–1.11) were associated with an increased risk of GDM.

A history of abortion was associated with an increased risk of GDM in pregnant women, which may be a risk factor for predicting GDM.