Published online Mar 19, 2026. doi: 10.5498/wjp.v16.i3.116848
Revised: December 20, 2025
Accepted: December 31, 2025
Published online: March 19, 2026
Processing time: 93 Days and 23.1 Hours
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.
To investigate the effects of anxiety and depressive symptoms during pregnancy on the Apgar score and birth weight of newborns.
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.
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).
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.
Core Tip: This study demonstrates that anxiety [Self-Rating Anxiety Scale (SAS)] and depression [Self-Rating Depression Scale (SDS)] symptoms during pregnancy are significant independent risk factors for adverse neonatal outcomes, including lower Apgar scores and reduced birth weight. The SAS and SDS showed high predictive value (area under the curve: 0.958 and 0.979, respectively). The findings underscore the critical need for early screening and intervention for maternal psychological distress to improve neonatal health.