{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T13:01:24Z","timestamp":1789822884566,"version":"4.0.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Miscarriage is a major public health concern in low and middle-income countries (LMICs) like Nepal. This study aims to examine the factors associated with miscarriage among pregnant women of reproductive age (15\u201349 years) in the past 15 years.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>There were a total of weighted sample of 26,376 cross-sectional pregnancy data from Nepal Demographic and Health Surveys (NDHS) 2001, 2006, 2011, and 2016 combined together, which was used in the study. Multilevel logistic regression analysis that adjusted for cluster and survey weights was used to identify factors associated with miscarriage among pregnant women of reproductive age in Nepal.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The results showed that maternal age, contraception, tobacco smoking, wealth index, respondents\u2019 educational status, and, caste\/ethnicity were found to be strong factors of miscarriage in Nepal. The likelihood of having a miscarriage among older women (\u226540 years) was more than 100% (aOR = 2.12, 95% CI [1.73, 2.59]), among non-users of contraception was 88.9% (aOR = 1.88, 95% CI [1.68, 2.11]) (p&lt;005) and non-smoking women had a 19% lower odds of miscarriage (aOR = 0.81, 95% CI [0.69, 0.95]). Respondents from the richest wealth index had 50% (aOR = 1.50, 95% CI [1.22, 1.85]) higher likelihood of miscarriage. Mothers with only primary education had a 25% higher chance of miscarriage (aOR = 1.25, 95% CI [1.09, 1.44]) compared to those with secondary and higher secondary education. In relation to caste\/ethnicity, Dalits had 13% lesser likelihood (aOR = 0.87, 95% CI [0.74, 1.02]) and Janajatis had 26% lower chances of a miscarriage than Brahmin\/Chettri (aOR = 0.74, 95% CI [0.64, 0.85]).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Findings from this study show that miscarriages are associated with maternal age, use of contraception, smoking, wealth index, caste, and ethnicity. Interventions aimed to improve use of contraceptives, avoiding smoking and pregnancy planning on the basis of maternal age, are needed to prevent miscarriage. Also, women from Brahmin ethinicity and those with the highest income index require greater attention when it comes to miscarriage prevention strategies in Nepal.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302001","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T17:26:35Z","timestamp":1714411595000},"page":"e0302001","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Factors associated with miscarriage in Nepal: Evidence from Nepal Demographic and Health Surveys, 2001\u20132016"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6310-8074","authenticated-orcid":true,"given":"Sharadha","family":"Hamal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7233-5104","authenticated-orcid":true,"given":"Yogendra B.","family":"Gurung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6701-6355","authenticated-orcid":true,"given":"Bidhya","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabin","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanda Lal","family":"Sapkota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0582-0781","authenticated-orcid":true,"given":"Vijaya Laxmi","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"issue":"2","key":"pone.0302001.ref001","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0301-2115(01)00613-3","article-title":"Risk factors in miscarriage: a review.","volume":"102","author":"A Garc\u0131a-Engu\u0131danos","year":"2002","journal-title":"European Journal of Obstetrics & Gynecology and Reproductive Biology"},{"issue":"8","key":"pone.0302001.ref002","doi-asserted-by":"crossref","first-page":"e0236435","DOI":"10.1371\/journal.pone.0236435","article-title":"Association between obesity and miscarriage among women of reproductive age in Nepal.","volume":"615","author":"PR Ghimire","year":"2020","journal-title":"PLoS One."},{"key":"pone.0302001.ref003","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1007\/s10654-016-0190-2","article-title":"Smoking, 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