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Effect of anxiety and depression symptoms in pregnancy on Apgar score and birth weight of newborns
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DOI：10.5498/wjp.v16.i3.116848.png)
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Abstract
En 中文
BACKGROUND Anxiety and depression during pregnancy are relatively common among pregnant women, with a prevalence rate reaching 30% in some regions of China. Existing studies suggest that maternal psychological states during pregnancy may influence fetal development through neuroendocrine mechanisms and are associated with neonatal outcomes. However, the relationship between these factors and specific neonatal indicators such as Apgar score and birth weight remains incompletely understood. AIM To investigate the effects of anxiety and depressive symptoms during pregnancy on the Apgar score and birth weight of newborns. METHODS This study enrolled 100 primiparous women who registered and delivered at our hospital between October 2021 and October 2024. Participants were categorized into a normal group (70 cases) and an adverse outcome group (30 cases) based on neonatal outcomes. We collected and compared the general information, sleep status, mode of delivery, fasting blood glucose, and other clinical indicators of the two groups of pregnant women in the third trimester. Using logistic regression analysis, receiver operator characteristic (ROC) curves, and correlation analysis, we examined the relationship between pregnancy anxiety/depression symptoms and neonatal Apgar scores and birth weight. RESULTS The adverse outcome group exhibited significantly higher Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), pregnancy stress scores, and fasting blood glucose levels compared to the normal group (all P < 0.05). Additionally, they showed poorer sleep quality, lower natural delivery rates, shorter gestational age, lower newborn birth weight, shorter body length, and lower 5-minute Apgar scores. Logistic regression analysis revealed that SAS, SDS, poor sleep quality, and pregnancy stress scores were independent risk factors for adverse neonatal outcomes (all P < 0.05). ROC analysis demonstrated that SAS and SDS had area under the curve values of 0.958 and 0.979, respectively, indicating strong predictive power for adverse neonatal outcomes (all P < 0.05). Correlation analysis showed negative correlations between anxiety/depression scores and 5-minute Apgar scores (R = -0.60, P < 0.001; R = -0.66, P < 0.001, respectively) and birth weight (R = -0.80, P < 0.001; R = -0.81, P < 0.001, respectively). CONCLUSION Pregnancy-related anxiety, depressive symptoms, poor sleep quality, and high stress levels are independent risk factors for adverse neonatal outcomes. The SAS and SDS scales demonstrate strong predictive value for such outcomes. Clinicians should prioritize maternal mental health, which supports healthy neonatal development.
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