Interactive tele-mental health interventions for maternal depression across perinatal stages: A systematic review and meta-analysis.

BACKGROUND

Interactive tele-mental health (TMH) interventions have been increasingly used to address mental health issues during the perinatal period. However, their effectiveness across perinatal stages remains unclear. This study aimed to evaluate and compare the effectiveness of TMH interventions for depressive and anxiety symptoms across pregnancy, the perinatal period, and the postpartum period.

METHODS

PubMed, Embase, Web of Science, Cochrane Library, PsycINFO, CINAHL, ClinicalTrials.gov, CNKI, and Wanfang were searched up to December 2025 to identify randomized controlled trials (RCTs) comparing TMH with usual care or other control conditions. Standardized mean differences (SMDs) were pooled using a random-effects model.

RESULTS

A total of 23 RCTs were included. TMH interventions significantly reduced depressive symptoms (SMD = -0.65, 95% CI -0.95 to -0.35; I2 = 95.2%) and anxiety symptoms (SMD = -0.69, 95% CI -1.01 to -0.36; I2 = 94.1%). Subgroup analyses showed significant improvements in the postpartum period, while pregnancy and perinatal period effects were not statistically significant. Secondary outcomes indicated reduced maternal stress and improved self-efficacy and social support.

CONCLUSIONS

TMH interventions were associated with reductions in depressive and anxiety symptoms, with the strongest effects observed during the postpartum period. Further high-quality studies are needed to evaluate long-term effectiveness and identify optimal intervention strategies.