Prevalence and determinants of miscarriage in Bangladesh: a trimester specific analysis

Background Miscarriage is a common adverse pregnancy outcome worldwide, yet its burden and determinants remain insufficiently documented in many low- and middle-income countries, particularly for early gestational losses. This study estimates the prevalence of miscarriage in Bangladesh and examines socio-demographic and reproductive correlates, with attention to trimester-specific patterns. Methods We analyzed 9,487 pregnancies reported within three years preceding the 2022 Bangladesh Demographic and Health Survey. Miscarriage was defined as involuntary pregnancy loss before 28 weeks of gestation and further classified into first- and second-trimester losses. Generalized estimating equation (GEE) models with a logit link were used to estimate population-averaged associations between selected covariates and miscarriage outcomes while accounting for clustering of multiple pregnancies within women. Results Overall, 10.6% of pregnancies ended in miscarriage, with 78.2% occurring in the first trimester. Higher odds of miscarriage were observed among women aged 35–49 years, women who were currently working, and those whose first birth occurred at age 20 years or later. Rural residence was associated with lower odds of overall and second-trimester miscarriage. Unintended pregnancy was strongly associated with second-trimester miscarriage. Conclusions Miscarriage remains a substantial reproductive health concern in Bangladesh, with determinants varying by gestational stage. The findings highlight the importance of early pregnancy monitoring and targeted reproductive health support, particularly for older and working women. Longitudinal studies are needed to clarify causal pathways and better capture early pregnancy losses.