Internet-delivered psychological interventions for reducing depressive, anxiety symptoms and fear of childbirth in pregnant women: A meta-analysis and meta-regression
Abstract
Objective The current review aims to (1) investigate the effectiveness of Internet-based psychological intervention in reducing depressive, anxiety, and stress symptoms and fear of childbirth among pregnant women at post-intervention and follow-up; (2) compare the effects of the intervention using different psychological principles; and (3) explore potential covariates on the intervention effect.Methods A literature search of seven databases was carried out to identify published and unpublished randomized controlled trials (RCTs) in English without any time limitation up to February 2021. Meta-analysis and meta-regression were conducted using Comprehensive Meta-analysis software. This review protocol was registered on PROSPERO (CRD42021235565).Results Sixteen RCTs involving 3894 pregnant women were included from more than 23 countries. Internet-delivered psychological interventions were found to significantly (p < 0.05) reduce depressive (g = -0.16 to -0.32) and anxiety (g = -0.22 to -0.33) symptoms with small effect sizes at post-intervention and follow-up during 6 to 8 weeks postpartum compared with those in the comparator group. However, there was insufficient evidence for fear of childbirth and stress symptoms. Our subgroup analyses found that psychological interventions adopting component of cognitive behavioral therapy (g = -0.29) or mindfulness therapy (g = -0.62) showed beneficial effects to improve depressive symptoms among pregnant women. Univariate random-effect regression analyses showed that the attrition rate was a significant covariate (Z = -2.33, p = 0.02) on depressive symptoms. The certainty of main outcomes was graded from low to very low in accordance with the GRADE criteria.Conclusions Our reviews suggested that Internet-delivered psychological intervention may complement usual antenatal care in the improvement of depressive and anxiety symptoms. Future trials involving a large-scale sample are needed to improve the methodological quality.
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Universal prevention (e.g., CBT, IPT, mindfulness, and psychoeducation) during pregnancy is effective in decreasing symptoms of maternal distress compared to routine care.
“Studies suggest that universal prevention (e.g., CBT, IPT, mindfulness, and psychoeducation) during pregnancy is effective in decreasing symptoms of maternal distress compared to routine care and recommends psychotherapy as a part of standard prenatal self-care [178, 194, 195].”
From Brain structural and functional outcomes in the offspring of women experiencing psychological distress during pregnancy (2024) · cites this paper as [178]
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The long-awaited EAPM 2022 meeting in Vienna
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PRINCIPLES OF ADULT SUBJECTIVITY DEVELOPMENT IN THE VIRTUAL EDUCATIONAL SPACE
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Nurse-Led Care: A Case Report of Twin Pregnancy Complicated by Ureteral Calculus and Thyrotoxicosis
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- Authors
- Neo, H. S., Tan, J. H., Ang, W. H. D., & Lau, Y.
- Affiliations
- KK Women's and Children's Hospital (SG)
- National University of Singapore (SG)
- Corresponding author
- Lau, Ying
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2022-06
- Volume
- 157
- Pages
- 110790
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W4221066285
- Cited by
- 32
- References
- 87
- Citations by year
- 2026: 10 · 2025: 5 · 2024: 8 · 2023: 7 · 2022: 2
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Education - Singapore (NUHSRO/2017/054/T1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- pregnant women, depressive symptoms, anxiety symptoms, fear of childbirth, stress symptoms, cognitive behavioral therapy, mindfulness therapy, attrition rates, prenatal care, postpartum depression
- MeSH terms
- Psychosocial Intervention, Anxiety, Depression, Fear, Female, Humans, Pregnancy, Internet, Pregnant People, Pregnant Women
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