Association between the salinity level with miscarriage and unintended pregnancy in Bangladesh: Impact of salinity level on miscarriage and unintended pregnancy in Bangladesh.

Miscarriage is a significant public health concern worldwide, particularly in developing nations like Bangladesh. Moreover, people in coastal areas are more affected by miscarriage as compared to other areas. Increasing sea levels and salinity is the main reason for this discrepancy. This study aimed to investigate the association between different salinity levels (S1, S2, S3, S4, and S5) and miscarriage and unintended pregnancy. The outcome variables are pregnancy-related outcomes (miscarriage, unintended pregnancy), and the independent variables are different salinity levels. A frequency table and correlation analysis were done to find the descriptive scenarios of miscarriage, unintended pregnancy, and salinity levels. We found 621 miscarriage patients and 2271 unintended pregnant patients in our study. Furthermore, the Poisson regression model was used to observe the incidence of miscarriage and unintended pregnancy for different salinity levels. A higher amount of miscarriage and unintended pregnancy rate was found in Dhaka and Khulna, while these rates were lower in Barisal and Chittagong. However, the salinity levels were highest in Barisal and Khulna. Both miscarriage and unintended pregnancy are highly and negatively correlated with salinity levels. The Poisson regression model shows that the salinity levels s1-s5 are strongly associated with miscarriage. Lower and moderate levels of salinity are strongly associated with miscarriage than higher levels of salinity. Again, the average number of miscarriages decreases with the salinity levels. Likewise, unintended pregnancy was also negatively associated with salinity levels. However, it only reported a significant association with lower and moderate salinity levels, and higher salinity levels did not affect unintended pregnancy. Taking initiatives for raising awareness from government and non-government organizations, setting up deep tube water pumps extensively, and properly treating coastal areas women during pregnancy would be the ideal next step to reduce the miscarriage and unintended pregnancy rate in coastal zones in Bangladesh.