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

Gita Nirmala SARI; Satoyo IKEHARA; Kanami TANIGAWA; Yoko KAWANISHI; Ehab S ESHAK; Tadashi KIMURA; Tomotaka SOBUE; Hiroyasu ISO

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

Author: Gita Nirmala SARI ¹ ; Satoyo IKEHARA ¹ ; Kanami TANIGAWA ² ; Yoko KAWANISHI ² ; Ehab S ESHAK ¹ ; Tadashi KIMURA ³ ; Tomotaka SOBUE ¹ ; Hiroyasu ISO ²
Author Information

1. Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University.
2. Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University.
3. Obstetrics and Gynecology, Osaka University Graduate School of Medicine.
Publication Type:Journal Article
Keywords: Apgar score; Birth cohort; Kessler Distress Scale; Maternal distress
MeSH: Humans; Female; Pregnancy; Japan/epidemiology*; Apgar Score; Infant, Newborn; Adult; Stress, Psychological/epidemiology*; Male; Young Adult; Pregnancy Complications/epidemiology*; Mothers/psychology*; Risk Factors
From:Environmental Health and Preventive Medicine 2025;30():25-25
CountryJapan
Language:English
Abstract: BACKGROUND: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.
METHODS: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.
RESULTS: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.
CONCLUSION: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.