Prevalence of anxiety, depression, and coping strategies among pregnant women attending a tertiary care center in Nepal

Background: Anxiety and depression are common yet under-recognized complications of pregnancy in low- and middle-income countries. This study assessed the prevalence of antenatal anxiety, depression, and coping strategies among pregnant women attending a tertiary care center in Nepal. Methods: A cross-sectional study was conducted among 310 pregnant women visiting the antenatal outpatient clinic. Anxiety and depression were assessed using the Nepali versions of the Hospital Anxiety and Depression Scale–Anxiety Subscale and Edinburgh Postnatal Depression Scale. Coping strategies were evaluated using the COPE Scale. Sociodemographic and obstetric factors were analyzed using chi-square and t -tests. Results: Depressive symptoms were present in 26.7% of participants and anxiety symptoms in 20.7%. Depression was significantly associated with maternal age (16–24 years and ≥35 years) and lower household income. Anxiety was highest among first-trimester women, showing a significant association with gestational age. No significant associations were identified with ethnicity, residence, family type, occupation, education, gravidity, birth spacing, pregnancy complications, or chronic illness. Women with lower education and those unemployed demonstrated higher coping scores than their counterparts. Conclusion: A considerable proportion of pregnant women exhibited previously unrecognized anxiety and depression, with age, income, and early gestation as key risk factors. Routine screening and targeted psychosocial support during antenatal care may help identify vulnerable groups and improve maternal mental health outcomes in Nepal.