Associations of Internet Use and Pregnancy Loss with Depression and Anxiety among Women in Bangladesh: Evidence from the 2022 BDHS

Background Bangladeshi married women experience a high prevalence of mental health disorders such as depression and anxiety, but the intersection of reproductive life, digital connectivity, and geographical disparities has been less researched. The research examines associations between internet use, pregnancy loss, and mental health symptoms with spatial and temporal trends. Methods The study employed nationally representative data from the 2022 Bangladesh Demographic and Health Survey (BDHS), which included 19,987 ever-married women. Depression was assessed using PHQ-9 scores, and anxiety was evaluated using GAD-7 scores. Stepwise multinomial logistic regression was used for this study. Spatial analyses highlight division-wise prevalence of mental health outcomes, exposure to the internet status, and pregnancy loss. Findings Depression and anxiety were present in 5.13% and 4.48% of women, respectively. Near one-fifth (23.3%) experienced pregnancy loss, and 28.5% reported internet use. In comparison with women with no loss, women with one loss had significantly higher odds of anxiety (AOR 1.31, 95% CI 1.20–1.43) and depression (AOR 1.29, 95% CI 1.18–1.41), while women with two or more losses had significantly higher risk (anxiety AOR 1.82, CI 1.55–2.14; depression AOR 1.43, CI 1.24–1.68). Internet use during the past 12 months was associated with reduced odds of anxiety (AOR 0.65, CI 0.59–0.71) and depression (AOR 0.77, CI 0.69–0.85). Regional disparities were observed; Rangpur had the highest mental health burden and Dhaka the lowest. Temporal trends showed declining rural-urban inequalities in internet use and call termination rates, which reflected growing rural access and evolving norms. Conclusion Pregnancy loss is a significant risk to poor mental health, but recent internet use has a protective effect. Geospatial disparities in mental health outcomes are consistent with trends in digital access and reproductive burden. The findings suggest the need for inclusive digital, reproductive, and psychosocial health programs, particularly in high-risk regions such as Rangpur. Building digital inclusion could be a powerful and scalable solution to counteract mental health disparities in low-resource settings.