Introduction: Maternal anxiety during pregnancy has been associated with various adverse birth outcomes, including alterations in Brain-Derived Neurotrophic Factor (BDNF) levels, birth weight, length, and APGAR scores. This study aims to examine the relationship between maternal anxiety levels and neonatal outcomes among pregnant women in Padang, Indonesia. Methods: A cross-sectional study was conducted with 85 pregnant women who were approaching labor at a hospital in Padang. Anxiety levels were measured using the Zung Self-Rating Anxiety Scale (ZSAS), while neonatal outcomes such as birth weight, length, and APGAR scores were recorded. BDNF levels were measured using the ELISA method. Statistical analysis was performed using Pearson correlation and One-Way ANOVA tests to assess the relationship between anxiety levels and neonatal outcomes. Results: The results showed that 84.5% of participants experienced anxiety, with 40% having moderate anxiety and 27.1% having severe anxiety. A significant association was found between maternal anxiety and BDNF levels (p = 0.000), with higher anxiety associated with lower BDNF. A weak but significant negative correlation was observed between maternal anxiety and baby length (r = -0.224, p = 0.039). A strong negative correlation was identified between anxiety and APGAR scores (r = -0.661, p = 0.000). However, no significant relationship was found between maternal anxiety and birth weight (r = -0.121, p = 0.270). Conclusions: Maternal anxiety significantly influences BDNF levels, baby length, and APGAR scores but does not significantly affect birth weight. These findings underscore the importance of addressing maternal mental health during pregnancy and implementing interventions to reduce anxiety for better neonatal outcomes.