BMJ open · 2026
Anxiety and depressive symptoms in women with disabilities during pregnancy and childbirth: an analysis of Nepal demographic and health survey 2022 data.
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Devkota Hridaya Raj, Adhikary Pratik, Bohora Jaslina, Lama Kalyan, Poudel Sasmita
Аннотация
OBJECTIVE: To estimate the prevalence and severity of depressive and anxiety symptoms among women with and without disabilities, assess differences by pregnancy and recent childbirth status and examine the association between disability status and depressive and anxiety symptoms after adjustment for selected socio-demographic characteristics.
DESIGN AND SETTING: Cross-sectional analysis of nationally representative data from the Nepal Demographic and Health Survey 2022.
PARTICIPANTS: 7442 women aged 15–49 years who completed the disability and mental health modules.
OUTCOME MEASURES: Moderate-to-severe depressive symptoms measured using the Patient Health Questionnaire-9 and moderate-to-severe anxiety symptoms measured using the Generalised Anxiety Disorder-7 scale. Disability status was assessed using the Washington Group Short Set.
STATISTICAL ANALYSIS: Weighted descriptive analyses estimated prevalence by disability and reproductive status. Multivariable logistic regression models examined associations between disability and mental health outcomes, after adjustment for socio-demographic factors.
RESULTS: Women with disabilities had higher prevalence of moderate-to-severe anxiety (12.4% vs 6.3%) and depressive symptoms (9.3% vs 5.0%) than women without disabilities. Disability remained associated with increased odds of depressive symptoms (adjusted OR 1.79, 95% CI 1.43 to 2.23) and anxiety symptoms (adjusted OR 1.89, 95% CI 1.56 to 2.30). Dalit caste, marital status and household wealth were also associated with mental health outcomes in the adjusted models, while pregnancy status and recent childbirth were not significantly associated with either outcome.
CONCLUSIONS: Women with disabilities in Nepal experience a disproportionately high burden of depressive and anxiety symptoms that extends beyond the perinatal period. Disability-inclusive, intersectionality-informed mental health strategies integrated into primary and reproductive health services are needed to address these persistent mental health inequities.
DESIGN AND SETTING: Cross-sectional analysis of nationally representative data from the Nepal Demographic and Health Survey 2022.
PARTICIPANTS: 7442 women aged 15–49 years who completed the disability and mental health modules.
OUTCOME MEASURES: Moderate-to-severe depressive symptoms measured using the Patient Health Questionnaire-9 and moderate-to-severe anxiety symptoms measured using the Generalised Anxiety Disorder-7 scale. Disability status was assessed using the Washington Group Short Set.
STATISTICAL ANALYSIS: Weighted descriptive analyses estimated prevalence by disability and reproductive status. Multivariable logistic regression models examined associations between disability and mental health outcomes, after adjustment for socio-demographic factors.
RESULTS: Women with disabilities had higher prevalence of moderate-to-severe anxiety (12.4% vs 6.3%) and depressive symptoms (9.3% vs 5.0%) than women without disabilities. Disability remained associated with increased odds of depressive symptoms (adjusted OR 1.79, 95% CI 1.43 to 2.23) and anxiety symptoms (adjusted OR 1.89, 95% CI 1.56 to 2.30). Dalit caste, marital status and household wealth were also associated with mental health outcomes in the adjusted models, while pregnancy status and recent childbirth were not significantly associated with either outcome.
CONCLUSIONS: Women with disabilities in Nepal experience a disproportionately high burden of depressive and anxiety symptoms that extends beyond the perinatal period. Disability-inclusive, intersectionality-informed mental health strategies integrated into primary and reproductive health services are needed to address these persistent mental health inequities.