Abstract
BACKGROUND: Mental health disorders, such as depression and anxiety, are notable among Bangladeshi married women. Nevertheless, to the best of our knowledge, none study has examined combinedly association between pregnancy loss, internet use, and mental health indicators in Bangladesh. This study aims to explore associations between pregnancy loss, internet use, and mental health symptoms as well as to detect regional disparities among ever married women in Bangladesh. METHODOLOGY: This study analyzed 19,987 ever-married women from the Bangladesh Demographic and Health Survey (BDHS) 2022. Depression and anxiety were evaluated using PHQ-9 and GAD-7 scales, respectively. Stepwise survey-weighted multinomial logistic regression was used to analyze the association of mental health indicators with pregnancy loss and internet use. Spatial analysis explored division-wise patterns of mental health outcomes, pregnancy loss, and internet use. FINDINGS: Among 19,987 ever-married women, 5.13% moderate to severe depression and 4.48% experienced moderate to severe anxiety. Pregnancy loss was associated with higher odds of depression and anxiety: women with one loss (anxiety AOR = 1.31, 95% CI: 1.20–1.43); and (depression AOR = 1.29, 95% CI: 1.18–1.41) and those with two or more losses (anxiety AOR 1.82, 95% CI: 1.55–2.14); and depression (AOR = 1.43, 95% CI: 1.24–1.68) compared with women with no pregnancy loss. Internet use in the past 12 months was associated with lower odds of anxiety (AOR = 0.65, 95% CI: 0.59–0.71) and depression (AOR = 0.77,95% CI: 0.69–0.85)). Regional disparities explored Rangpur division is the highest burden of mental health symptoms and Dhaka is the lowest. CONCLUSION: Pregnancy loss is linked to with a higher risk of depression and anxiety, while internet use is to a lower risk. Regional variations reveal differences in reproductive experiences and internet access. Therefore, enhancing reproductive health programs and internet access are necessary to reduce depression and anxiety in high burden areas. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-025-04166-4.