Antenatal psychological interventions may ameliorate postpartum depression: a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: P = 0.02

• Effect Size: OR = 0.73 (27% reduction in odds)

• Primary Outcome: Postpartum depression incidence within 6 weeks

• Nnt Or Sensitivity: NNT approximately 14-20 (estimated from OR, assuming baseline risk 10-15%)

• Confidence Interval: 95% CI [0.57-0.95]

Clinical Application

Moderate - requires trained personnel and structured programs, but interventions are generally accessible Aligns with RACGP guidelines for perinatal mental health screening. Could be integrated into existing antenatal care pathways. PBS may not cover all intervention types, requiring consideration of cost-effectiveness Pregnant women without severe mental illness receiving routine antenatal care

Abstract

BACKGROUND: This study aimed to systematically evaluate the effects of psychological interventions during pregnancy on the intervention outcomes and incidence rate in women with postpartum depression. METHODS: Databases (PubMed, Medline, Web of Science, Cochrane Library, EMBASE) were searched from inception to December 2024 for randomised controlled trials assessing prenatal psychological interventions (e.g., mindfulness, psychosocial support) in pregnant women without severe mental illness. Primary outcomes included Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale-10 (PSS-10), Spielberger State-Trait Anxiety Inventory (STAI) scores, and PPD incidence within 6 weeks postpartum. Quality was assessed using the Cochrane risk-of-bias tool; meta-analysis was performed with RevMan 5.3. RESULTS: A total of 10 articles were included, with 6700 study subjects in total, including 3345 in the intervention group and 3355 in the control group, all of which were randomised controlled trials. The incidence rate of postpartum depression in the intervention group was significantly reduced (OR = 0.73, 95% CI [0.57-0.95], P = 0.02). The scores of EPDS, PHQ-9, PSS-10, and STAI in the intervention group were all lower than those in the control group. CONCLUSION: Psychological interventions during pregnancy can significantly reduce postpartum depression-related scale scores and incidence rates, and improve depressive symptoms, anxiety, and perceived stress. However, due to the heterogeneity of intervention types, this study cannot determine the optimal intervention method and thus provides preliminary evidence for clinical prevention. Clinicians should select interventions based on resource availability and individual characteristics of pregnant women, while future studies should focus on direct comparisons of different intervention types to provide more targeted guidance. Postpartum depression is a common mental health problem that affects many women after childbirth. It can harm both the mother’s well-being and the baby’s development. This study combined data from ten clinical trials, including 6,700 participants, to evaluate whether psychological interventions during pregnancy can help prevent postpartum depression. The results showed that women who received psychological support—such as mindfulness training, counselling, or group therapy—had fewer depressive symptoms, lower anxiety and stress levels, and a significantly reduced incidence rate compared with those who received routine care. These findings suggest that providing psychological care during pregnancy is an effective way to reduce the risk of postpartum depression and to promote mental health for both mothers and infants. Early psychological support should be considered an important part of prenatal care.

References

1. 1.Chen, Y., Zhao, B., & Chen, Z. (2026). Antenatal psychological interventions may ameliorate postpartum depression: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology, 1-8. https://doi.org/10.1080/01443615.2026.2651874