Global research trends and future frontiers in the immunology of spontaneous abortion: a 25-year scientometric analysis

Background: The intricate role of the immune system in spontaneous abortion is a critical and rapidly evolving field of reproductive medicine. Methods: We conducted a scientometric analysis of 4,495 publications on the immunology of spontaneous abortion retrieved from the Web of Science Core Collection for the period 2000-2025. Bibliometric tools, including CiteSpace and HistCite, were used to analyze publication trends, collaboration networks, co-citation patterns, and keyword evolution to identify the intellectual structure and research frontiers. Results: The annual publication output experienced rapid growth from 2008, peaking in 2022. The American Journal of Reproductive Immunology was the most prolific journal, while China and the USA were the leading countries in scientific collaboration. Co-citation analysis identified foundational works by authors such as Atik RB (2018) and Quenby S (2021). Burst detection analysis revealed a dynamic shift in research hotspots over time, with recent high-strength keywords including "recurrent implantation failure" (strength: 15.87), "chronic endometritis" (13.4), and "maternal-fetal interface" (10.35). Timeline and cluster analyses further pinpointed the field's evolution from foundational topics like "tolerance" and "antiphospholipid syndrome" to current emerging frontiers. These new frontiers are concentrated in distinct clusters, prominently including #0 recurrent pregnancy loss, #2 maternal-fetal interface, #11 chronic endometritis, and #12 COVID-19. Alluvial flow visualization confirmed that themes related to "regulatory_t_cells" and therapeutic interventions at the "maternal-fetal_interface" represent major developing research streams. Conclusion: This study comprehensively maps the historical landscape and dynamic evolution of research on immunology in spontaneous abortion, identifying key emerging frontiers that may represent important directions for future investigation in the field.