Acta Scientific Women's Health (ASWH)(ISSN: 2582-3205)

Research Article Volume 3 Issue 6

Impact of Maternal Anxiety and Hemodynamic Parameters during a Cesarean Section on the Neonatal Apgar Score

Mehrnush Mostafayi1, Behzad Imani2*, Shirdel Zandi1 and Faeze Jongi3

1MSc Student in Operating Room, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
2Assistant Professor, Department of Operating Room, Faculty of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
3Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran

*Corresponding Author: Behzad Imani, Assistant Professor, Operating Room Department, School of Paramedical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.

Received: May 19, 2021; Published: May 28, 2021


Background and Objective: The stress and anxiety that a mother experiences during a cesarean section, by stimulating the sympathetic nerves, leads to changes in vital signs that can have adverse effects on the health of the fetus. Therefore, the aim of this study was to determine the relationship between neonatal Apgar score and maternal anxiety and hemodynamic parameters in cesarean section.

Methods: This cross-sectional descriptive-analytical study was performed on 120 patients who were candidates for cesarean section in Fatemieh Hospital in Hamadan in June and July 2020. Samples were selected by random sampling. Data collection tools were a demographic information questionnaire, a vital signs sheet, and neonatal Apgar score, and Spielberger situational anxiety. Data were analyzed using SPSS software version 16.

Result: The results of this study showed that the correlation between the first and fifth minute Apgar score of the infant and anxiety was positively and insignificantly (p ≤ 0.05). Also, there was no significant difference between the first and fifth minute Apgar score of the infant with heart rate and temperature, but there was a significant relationship between respiration and systolic and diastolic blood pressure.

Conclusion: According to the results, there is no significant relationship between the Apgar score of the first and fifth minute of the baby with anxiety, heart rate and temperature, but there is a significant relationship between respiration and systolic and diastolic blood pressure.

Keywords: Anxiety; Apgar Score; Cesarean Section; Vital Signs


  1. Abalos E., et al. “Caesarean section surgical techniques (CORONIS): a fractional, factorial, unmasked, randomised controlled trial”. Lancet9888 (2013): 234-248.
  2. Abbaspoor Z., et al. “Effect of foot and hand massage in post–cesarean section pain control: a randomized control trial”. Pain Management Nursing1 (2014): 132-136.
  3. Büyükyılmaz F and Aştı T. “The effect of relaxation techniques and back massage on pain and anxiety in Turkish total hip or knee arthroplasty patients”. Pain Management Nursing3 (2013): 143-154.
  4. Mostafayi M., et al. “Comparing Early Postoperative Maternal Complications in Elective and Emergency Cesarean Sections”. Journal of Midwifery and Reproductive Health3 (2020): 2368-2375.
  5. Kim W., et al. “Availability of preoperative anxiety scale as a predictive factor for hemodynamic changes during induction of anesthesia”. Korean Journal of Anesthesiology4 (2010): 328.
  6. Pokharel K., et al. “Nepalese patients' anxiety and concerns before surgery”. Journal of Clinical Anesthesia5 (2011): 372-378.
  7. Kain Z., et al. “Preoperative anxiety and postoperative pain in women undergoing hysterectomy: A repeated-measures design”. Journal of Psychosomatic Research6 (2000): 417-422.
  8. Pittman S and Kridli S. “Music intervention and preoperative anxiety: an integrative review”. International Nursing Review2 (2011): 157-163.
  9. Alehagen S., et al. “Fear of childbirth before, during, and after childbirth”. Acta Obstetricia et Gynecologica Scandinavica 1 (2006): 56-62.
  10. Saisto T., et al. “Psychosocial characteristics of women and their partners fearing vaginal childbirth”. British Journal of Obstetrics and Gynaecology5 (2001): 492-498.
  11. Mohammaditabar S., et al. “The survey on tendencies of primiparous women for selecting the mode of delivery”. Journal of Babol University of Medical Sciences3 (2009): 54-59.
  12. Sanchez SE., et al. “Risk of spontaneous preterm birth in relation to maternal depressive, anxiety and stress symptoms”. The Journal of Reproductive Medicine 58 (2013): 25.
  13. Ibanez G., et al. “Depression and anxiety in women during pregnancy and neonatal outcome: data from the EDEN mother–child cohort”. Early Human Development8 (2012): 643-649.
  14. Martini J., et al. “Anxiety disorders before birth and self-perceived distress during pregnancy: associations with maternal depression and obstetric, neonatal and early childhood outcomes”. Early Human Development5 (2010): 305-310.
  15. Berle J., et al. “Neonatal outcomes in offspring of women with anxiety and depression during pregnancy”. Archives of Women’s Mental Health3 (2005): 181-189.
  16. Field T., et al. “Pregnancy anxiety and comorbid depression and anger: effects on the fetus and neonate”. Depression and Anxiety3 (2003): 140-51.
  17. Alder J., et al. “Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature”. The Journal of Maternal-Fetal and Neonatal Medicine3 (2007): 189-209.
  18. Littleton H., et al. “Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: a meta-analysis”. American Journal of Obstetrics and Gynecology5 (2007): 424-432.
  19. Johnson R and Slade P. “Obstetric complications and anxiety during pregnancy: is there a relationship?” Journal of Psychosomatic Obstetrics and Gynecology1 (2003): 1-14.
  20. Mahram B. “Standardization of Spielberger's State Anxiety Inventory in Mashhad, Iran Master Thesis Assessment and Measurement in Psychology Faculty”. Alame Tabatabai University (1994).
  21. Bonnel A and Boureau F. “Labor pain assessment: validity of a behavioral index”. Pain 1 (1985): 81-90.
  22. Pavlov M., et al. “Obstetric and neonatal outcome in patients with anxiety disorders”. The Journal of Maternal-Fetal and Neonatal Medicine13 (2014): 1339-1342.
  23. Rajabi F., et al. “Correlation between anxiety in labor and duration as well as outcome of delivery in women attended to hospitals affiliated to Shahid Beheshti Medical University and Shahid Akbar Abadi Hospital” (2012).
  24. Hasanjanzadeh P and Faramarzi M. “Relationship between maternal general and specific-pregnancy stress, anxiety, and depression symptoms and pregnancy outcome”. Journal of Clinical and Diagnostic Research: JCDR4 (2017): VC04.
  25. Aslami E., et al. “A comparative study of mindfulness efficiency based on islamic-spiritual schemes and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women”. International Journal of Community Based Nursing and Midwifery2 (2017): 144.
  26. Zhao B., et al. “The relationship between epidural analgesia and intrapartum maternal fever and the consequences for maternal and neonatal outcomes: a prospective observational study”. The Journal of Maternal-Fetal and Neonatal Medicine (2021): 1-9.
  27. Nikooseresht M., et al. “Comparing the hemodynamic effects of spinal anesthesia in preeclamptic and healthy parturients during cesarean section”. Anesthesiology and Pain Medicine 3 (2016).
  28. Aya A., et al. “Patients with severe preeclampsia experience less hypotension during spinal anesthesia for elective cesarean delivery than healthy parturients: a prospective cohort comparison”. Anesthesia and Analgesia3 (2003): 867-872.
  29. Aya A., et al. “Spinal anesthesia-induced hypotension: a risk comparison between patients with severe preeclampsia and healthy women undergoing preterm cesarean delivery”. Anesthesia and Analgesia3 (2005): 869-875.
  30. Mendes F., et al. “Hemodynamic effects of spinal anesthesia for cesarean section are equivalent in severely preeclamptic and healthy parturients”. Journal of Anesthesia and Clinical Research (2011): 1-6.
  31. Parsa P., et al. “The Effect of Breathing Techniques on Maternal Behavioral Changes against Labor Pain and APGAR Score in Primiparous Women”. Pajouhan Scientific Journal2 (2020): 107-113.
  32. Ahmadi Z., et al. “The effect of breathing techniques in second stage of labor on delivery outcome”. Journal of Urmia Nursing and Midwifery Faculty12 (2017): 1024-1031.


Citation: Behzad Imani., et al. “Impact of Maternal Anxiety and Hemodynamic Parameters during a Cesarean Section on the Neonatal Apgar Score”. Acta Scientific Women's Health 3.6 (2021): 124-129.


Copyright: © 2021 Behzad Imani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate35%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is February 15, 2023.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US