Anxiety and depressive symptoms in women with disabilities during pregnancy and childbirth: an analysis of Nepal demographic and health survey data

BackgroundEvidence reveals an association between depressive symptoms and disability, while increased incidences of anxiety and depression are observed among women during pregnancy and childbirth. However, the experience of anxiety and depressive symptoms among women with disabilities is rarely studied in Nepal. ObjectiveDetermine the prevalence and factors associated with anxiety and depressive symptoms among reproductive-age women during pregnancy and delivery and compare their magnitude and severity between those with and without disabilities. MethodsData from the Nepal Demographic and Health Survey - 2022, was analyzed. The survey used the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scales for depression and anxiety measurements, respectively. ANOVA was used to compare data with multiple means across different groups, and logistic regression explored associations between outcomes and independent variables. ResultsThe overall prevalence of depression and anxiety among women aged 15 - 49 years was found at 5.9% and 22.2%, respectively. Most (78.4%) did not have depressive symptoms, while 15.7% had mild, 4.2% had moderate, and only 1.7% had severe depressive symptoms. Regarding anxiety, 77.8% had minimal or no symptoms, 20.8% had moderate symptoms, and only 1.4% had severe anxiety symptoms. Women with disabilities were 1.72 times more likely to experience depressive symptoms (OR 1.72, 95% CI 1.51 - 1.97; P<0.001), and 1.8 times more likely to experience anxiety (OR 1.80, 95% CI 1.56 - 2.05; P<0.001) compared to women without disabilities. Marital status, caste, and ethnicity were strongly associated with depression and anxiety (P<0.001), while pregnancy, religion, and household wealth were associated with depression (P<0.05). ConclusionThis study highlights the substantial mental health challenges among women of reproductive-age in Nepal, particularly those with disabilities, during pregnancy and childbirth. The study urges the prompt implementation of focused interventions and policies to address these disparities and improve the well-being of reproductive-age women in Nepal, with special attention to those with disabilities.