REVIEW article
Front. Psychiatry
Sec. Perinatal Psychiatry
This article is part of the Research TopicImproving Assessment and Management of Psychological Health in the Perinatal Period to Improve Outcomes for Children, their Parents and FamiliesView all 3 articles
Effects of prenatal psychotherapies and psychosocial interventions on depressive symptoms, anxious symptoms and stress: a systematic review and network meta-analysis
Provisionally accepted
- 1Xi'an Jiaotong University, Xi'an, China
- 2Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China, 710061, Xi'an, China
- 3The Nursing Department, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, P. R. China, Xi'an, China
- 4Department of Nursing, Chinese People's Liberation Army General Hospital, Beijing, P. R. China, 100039, Beijing, China
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Background: Perinatal psychological disorders introduce substantial influences on maternal and neonatal health. While numerous psychotherapies and psychosocial interventions have been developed and empirically evaluated in the management of perinatal psychological symptoms, the intervention efficacy and the optimal intervention modality remain inconclusive. Aim: To assess and compare the efficacy of diverse perinatal psychotherapies and psychosocial interventions for depressive symptoms, anxious symptoms and stress through a comprehensive systematic review with network meta-analysis. Methods: Eleven English and Chinese electronic databases were searched from the inceptions to November 30, 2024. The Revised Cochrane Risk of Bias tool for randomized trials was used to assess the quality of evidence. Standard pairwise meta-analyses were conducted for direct comparisons using Reviewer Manager 5.3, and network meta-analyses were performed using Stata16 and ADDIS1.16.5 for different types of interventions based on random-effects models. Design: A systematic review and network meta-analysis, with both qualitative and quantitative syntheses performed to produce a holistic investigation of intervention effectiveness. Results: A total of 85 randomized controlled trials were included in the analysis, among which 65 provided available data for quantitative synthesis. The synthesized results suggested prenatal psychotherapies and psychosocial interventions tend to be effective in reducing depressive symptoms, anxious symptoms and stress, with a standardized mean difference (SMD) of -0.70, - 0.81 and -1.05, respectively. Multicomponent interventions (SMD=-1.14), interpersonal psychotherapy (SMD=-0.75), cognitive behavioral therapy (SMD=-0.69), mindfulness-based intervention (SMD=-0.68) and psychoeducation (SMD=-0.14) could significantly decrease depressive symptoms. Acceptance and commitment therapy (SMD=-1.66), interpersonal psychotherapy (SMD=-1.24), counseling (SMD= -1.13), multicomponent intervention (SMD=- 0.86), mindfulness-based intervention (SMD=-0.84) and cognitive behavioral therapy (SMD=- 0.81) tend to be effective in relieving anxious symptoms. Multicomponent interventions (SMD=- 5.74), mindfulness-based intervention (SMD=-1.31), cognitive behavioral therapy (SMD=-1.03) and counseling (SMD=-0.82) appear to be effective strategies for the management of perinatal stress. Conclusions: Prenatal psychotherapies and psychosocial interventions are effective in reducing depressive symptoms, anxious symptoms and stress. To be detailed, multicomponent interventions, counseling and mindfulness-based intervention could be the superior opinions for relieving depressive symptoms, anxious symptoms and stress, respectively. Cognitive behavioral therapy might be a reasonable option that could produce satisfactory beneficial effect on all of these prenatal psychological problems.
Keywords: Psychotherapies and psychosocial interventions, Systematic review, Network meta-analysis, perinatal depressive symptoms, Perinatal anxious symptoms, perinatal stress
Received: 08 May 2025; Accepted: 13 Nov 2025.
Copyright: © 2025 Huo, YU, MA, Yang and LI. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaomei LI, roselee@xjtu.edu.cn
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