Effectiveness of cognitive behavioral therapy for postpartum depression: a systematic review and meta‑analysis.

BACKGROUND

Postpartum depression (PPD) affects 17.22% of women worldwide and represents a major public‑health concern. Cognitive-behavioral therapy (CBT) is a recommended intervention for PPD. However, evidence regarding its overall efficacy, additional clinical benefits, and real‑world performance across heterogeneous delivery formats remains insufficient. This meta‑analysis quantifies the efficacy of CBT compared with usual care, assesses the certainty of evidence, and descriptively explores intervention‑mode characteristics across included trials.

METHODS

We systematically searched PubMed, Embase, Web of Science, the Cochrane Library, and Scopus from inception to December 13, 2025. Eligible randomized controlled trials (RCTs) were included in the meta-analysis, and all statistical analyses were performed using STATA 18.0 software (StataCorp LLC, College Station, TX, USA).

RESULTS

Eight RCTs (1811 PPD participants) were included. CBT significantly reduced Edinburgh Postnatal Depression Scale (EPDS) scores (SMD = -0.59, 95% CI: -0.77 to -0.41) and increased the EPDS‑defined clinical improvement rate (RR = 1.84, 95% CI: 1.59 to 2.12). It may improve perceived social support, mitigating infant‑focused maternal anxiety and generalized anxiety symptoms. No group difference was found for infant surgency temperament (IBQ‑R‑SUR, SMD = 0.17, 95% CI: -0.04 to 0.38).

CONCLUSIONS

Findings from this meta-analysis point to potential benefits of CBT for core PPD-related symptoms and secondary outcomes. The certainty of evidence ranges from very low to moderate. Future research should prioritize high‑quality, long‑term trials of non‑specialist‑delivered digital CBT models to develop accessible perinatal mental‑health services.