This study examines the impact of flood exposure on pregnancy loss in 33 developing countries, analyzing 90,465 individual pregnancy loss records from 2010 to 2020. The findings indicate that gestational flood exposure is associated with an increased risk of pregnancy loss, with an odds ratio (OR) of 1.08 (95% CI: 1.04 - 1.11). This risk is particularly pronounced for women outside the peak reproductive age range (<21 or >35) and during mid to late pregnancy. Women dependent on surface water, with lower income or education levels, also face a higher risk. The study estimates that gestational flood events may be responsible for approximately 107,888 excess pregnancy losses annually across these countries, with a consistent upward trend from 2010 to 2020, more prominent in Central America, the Caribbean, South America, and South Asia. The results highlight the significant health disparities in maternal and child health exacerbated by flood events in a changing climate.This study examines the impact of flood exposure on pregnancy loss in 33 developing countries, analyzing 90,465 individual pregnancy loss records from 2010 to 2020. The findings indicate that gestational flood exposure is associated with an increased risk of pregnancy loss, with an odds ratio (OR) of 1.08 (95% CI: 1.04 - 1.11). This risk is particularly pronounced for women outside the peak reproductive age range (<21 or >35) and during mid to late pregnancy. Women dependent on surface water, with lower income or education levels, also face a higher risk. The study estimates that gestational flood events may be responsible for approximately 107,888 excess pregnancy losses annually across these countries, with a consistent upward trend from 2010 to 2020, more prominent in Central America, the Caribbean, South America, and South Asia. The results highlight the significant health disparities in maternal and child health exacerbated by flood events in a changing climate.