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

Abstract

Abstract Background: Recurrent pregnancy loss (RPL) imposes a substantial burden, but data from sub-Saharan Africa are limited. We aimed to determine risk factors for RPL at a tertiary private-not-profit hospital in Northern Uganda. Methods: We conducted an unmatched case-control study among pregnant women at a referral hospital in Northern Uganda from February to June 2023. Cases included women aged 15-49 with ≥2 miscarriages and pregnancy <28 weeks of gestation. The controls were pregnant women with no history of miscarriage. We used a structured questionnaire to collect data and multivariable logistic regression for analysis. Results: We included 56 participants (19 cases and 37 controls), the median age was 29 years (IQR 26-35). The major factor associated with RPL was single/divorced status (adjusted odds ratio (aOR): 8.2, 95%CI 1.15-58.27). There was no statistical evidence of association between pregnancy planning (aOR: 2.5, 95% CI: 0.62-9.88, p=0.197) or chronic medical illness (aOR: 4.7, 95% CI: 0.91-24.42, p=0.065) and RPL Conclusions: This small, single-centre study found an association between single/divorced marital status and RPL risk. However, wide confidence intervals warrant cautious interpretation. Small sample size and retrospective design limit conclusiveness but provide a basis for larger multi-centre studies on independent risk factors for RPL including chronic illnesses, uterine anomalies, and gynaecological procedures.