Meta-analysis of different internet-based cognitive behavioral interventions for women at high risk for postpartum depression.

OBJECTIVE

To evaluate the efficacy of Internet-based cognitive behavioral therapies (iCBTs) for women at high risk for postpartum depression (PPD) and examine the influence of screening tools and intervention timings.

METHODS

PubMed, Embase, Web of Science, and the Cochrane Library databases were searched for randomized controlled trials (RCTs) on iCBT for high-risk PPD through July 2026. Meta-analysis was conducted using RevMan 5.4.1.

RESULTS

A total of 11 RCTs involving 4065 participants were included. Meta-analysis revealed that compared with the control, iCBT significantly reduced the incidence rate of PPD in women at high risk for PPD (OR = 0.21, 95%CI [0.14, 0.33], P < 0.01). Regarding symptom scores, the iCBT group exhibited significantly lower depression scores (standardized mean difference [SMD = -0.34, 95% CI [-0.49, -0.19], P < 0.01) and anxiety scores (SMD = -0.24, 95% CI [-0.32, -0.17], P < 0.01) than the control group. Subgroup analyses revealed no significant differences in PPD incidence or depression improvement across screening tools or intervention timings, though further trials are needed to rule out potential moderating effects. Anxiety alleviation assessment may depend on the selected tool.

CONCLUSION

iCBT may reduce PPD incidence and alleviate depression and anxiety symptoms in high-risk women.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420251174544.