To investigate the changes of the levels of estrogen (E2), progesterone (P), and β-human chorionic gonadotropin (β-HCG) of pregnant women with recurrent spontaneous abortion (RSA) during the first trimester of pregnancy, and to study the levels of E2, P, andβ-HCG for predicting their spontaneous abortion again. Methods: 89 pregnant women with RSA during the first trimester of pregnancy were selected in study group, and 50 normal pregnant women without RSA during the first trimester of pregnancy were selected in control group between August 2017 and October 2020. The women in the study group were further divided into group A (32 cases with spontaneous abortion again) and group B (57 cases without spontaneous abortion again). The levels of E2, P, and β-HCG of the women in these groups during the first trimester of pregnancy (4, 6, 8, 10, and 12 gestational weeks) were detected. The differences of sex hormones levels of the women in these groups were analyzed, and the predictive values of the levels of E2, P, and β-HCG of the pregnant women with RSA during different gestational weeks for their pregnancy outcomes were analyzed. Results: The levels of E2, P, and β-HCG of the women in the study group during 4, 6, 8, 10, and 12 gestational weeks were significantly lower than those of the women in the control group, and which of the women in group A were significantly lower than those of the women in group B (all P<0.05). The area under the curve (AUC) of the E2 level of women in the study group during 4, 6, 8, 10, and 12 gestational weeks for predicting abortion of the women again were 0.743, 0.755, 0.748, 0.769, and 0.748, respectively. The area under the curve (AUC) of the P level of women in the study group during 4, 6, 8, 10, and 12 gestational weeks for predicting abortion of the women again were 0.857, 0.852, 0.707, 0.884, and 0.730, respectively. The area under the curve (AUC) of the P level of women in the study group during 4, 6, 8, 10, and 12 gestational weeks for predicting abortion of the women again were 0.617, 0.777, 0.919, 0.900, and 0.904, respectively. Conclusion: The levels of estrogen, P, and β-HCG of the pregnant women with RSA during the first trimester of pregnancy are abnormal, and which of those women with abortion again are lower. The detection of the sex hormone levels of the pregnant women with RSA is helpful for early prediction of abortion again, and which can provide reference for timely intervention.