# Association between maternal distress during pregnancy and lower 5-min-Apgar score of the offspring: the Japan Environment and Children’s Study

## TL;DR

This study finds that high levels of maternal distress during pregnancy are linked to a higher risk of low Apgar scores in newborns, particularly in preterm and low birth weight babies.

## Contribution

The study provides new evidence on the association between maternal distress and low Apgar scores in Japanese women, a population underrepresented in prior research.

## Key findings

- Moderate to severe maternal distress during mid-late pregnancy is associated with a higher risk of low 5-minute Apgar scores in newborns.
- The association is strongest in preterm births and low birth weight infants.
- The adjusted odds ratio for severe distress is 1.42 compared to low distress.

## Abstract

Although the influence of maternal distress during pregnancy on newborn Apgar scores has been studied in various populations, there is limited research specifically addressing this issue among Asian women. This study of Japanese women aims to investigate the association between maternal distress during pregnancy and the risk of a low 5-min-Apgar score among newborns.

We analyzed data from 87,765 mother-newborn pairs in the Japan Environment and Children’s Study. Using multivariable logistic regression, we estimated odds ratios (OR) and 95% confidence intervals (CI) for low Apgar scores (<7) at 5 minutes about maternal distress during early and mid-late pregnancy, as measured by the Kessler Psychological Distress Scale (K6). Apgar scores were obtained from newborns’ medical records.

A higher risk of low Apgar score in newborns at 5 minutes was found in mothers with moderate to severe distress than in those with low distress during mid-late pregnancy. The adjusted OR (95% CI) was 1.22 (1.05–1.42) for moderate distress (K6 = 5–12) and 1.42 (1.00–2.01) for severe distress compared to low distress (p for trend = 0.002). The positive association between maternal distress and the risk of low Apgar score was observed in preterm birth (<37 weeks) and low birth weight (<2,500 g) but not in term birth and normal birth weight.

Maternal distress during mid-late pregnancy was positively associated with the risk of low Apgar score of newborns, specifically in preterm birth and low birth weight.