Risk factors for recurrent pregnancy loss among women seeking care at a tertiary private-not-for-profit hospital in Northern Uganda: a case-control study

Recurrent pregnancy loss (RPL) imposes a substantial burden, but data from sub-Saharan Africa are limited. We compared selected factors associated with RPL among women seeking care at a tertiary private-not-profit hospital in Northern Uganda. We conducted an unmatched case-control study among pregnant women at St. Mary’s Hospital Lacor from February to June 2023. Cases included women aged 15–49 with ≥ 2 miscarriages and a current pregnancy < 28 weeks of gestation. The controls were pregnant women aged 15–49 years with no history of miscarriage. Data were collected via a structured, pretested questionnaire and clinical records. Factors associated with RPL were assessed using multivariable logistic regression. Fifty-six participants were included (19 cases and 37 controls), with a median age was 29 years (IQR 26–35). Single/divorced marital status was associated with higher estimated odds of RPL compared with married/cohabiting (adjusted odds ratio [aOR]: 8.2, 95%CI 1.15–58.27). There was no statistical evidence of an association between planned pregnancy (aOR: 2.5, 95% CI: 0.62–9.88) or chronic medical illness (aOR: 4.7, 95% CI: 0.91–24.42) and RPL. The adjusted estimates were imprecise, reflecting the small sample and sparse data. In this exploratory single-centre analysis, single/divorced marital status was associated with higher estimated odds of RPL; however, the wide confidence interval indicates substantial uncertainty around the magnitude of the association, and chance, selection bias, and residual confounding cannot be excluded. Larger, multi-centre studies incorporating standardised aetiological testing for additional risk factors and population-representative controls are needed to determine whether marital status is an independent risk factor for RPL.