Preventive and improvement effects of cognitive-behavioral therapy on postpartum depression: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YI Xueyang ¹ ,  CHU Xin ²

1. School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P. R. China;
2. Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, P. R. China;

Corresponding?author：

CHU Xin, Email: 18981883803@163.com

Keywords：

Cognitive-behavioral therapy; Pregnant women; Depression; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.202507095

Video：

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Objective To systematically review the intervention effect of cognitive-behavioral therapy on postpartum depression in pregnant and postpartum women. Methods The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the intervention effect of cognitive-behavioral therapy on postpartum depression in pregnant women from database inception to December 2024. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results A total of 9 RCTs involving 7 154 participants were included. The meta-analysis results showed that cognitive-behavioral therapy can reduce postpartum depression (SMD=?0.57, 95%CI ?0.87 to ?0.27, P<0.001) and anxiety (MD=?2.04, 95%CI ?3.57 to ?0.52, P=0.008) in pregnant women with depression, but the preventive effect of prenatal intervention on postpartum depression symptoms was not significant. Conclusion Cognitive-behavioral therapy may help improve the negative emotions of pre depression and anxiety in pregnant women with depression, but the preventive effect of prenatal cognitive-behavioral therapy intervention on postpartum depression symptoms is not yet clear.

Citation： YI Xueyang, CHU Xin. Preventive and improvement effects of cognitive-behavioral therapy on postpartum depression: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2026, 26(3): 309-313. doi: 10.7507/1672-2531.202507095 Copy

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2.	Kroska EB, Stowe ZN. Postpartum depression: identification and treatment in the clinic setting. Obstet Gynecol Clin North Am, 2020, 47(3): 409-419.
3.	肖意蘋, 張烜, 毛芳香, 等. 母親產后抑郁癥狀對嬰兒忽視的影響: 基于群體和個體視角的證據. 軍事護理, 2023, 40(7): 29-33.
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5.	Nakao M, Shirotsuki K, Sugaya N. Cognitive-behavioral therapy for management of mental health and stress-related disorders: recent advances in techniques and technologies. Biopsychosoc Med, 2021, 15(1): 16.
6.	Hertenstein E, Trinca E, Wunderlin M, et al. Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: a systematic review and meta-analysis. Sleep Med Rev, 2022, 62: 101597.
7.	Qin X, Liu C, Zhu W, et al. Preventing postpartum depression in the early postpartum period using an app-based cognitive behavioral therapy program: a pilot randomized controlled study. Int J Environ Res Public Health, 2022, 19(24): 16824.
8.	Van Lieshout RJ, Layton H, Savoy CD, et al. Public health nurse-delivered group cognitive behavioural therapy for postpartum depression: a randomized controlled trial. Can J Psychiatry, 2022, 67(6): 432-440.
9.	Van Lieshout RJ, Layton H, Savoy CD, et al. In-person 1-day cognitive behavioral therapy-based workshops for postpartum depression: a randomized controlled trial. Psychol Med, 2023, 53(14): 6888-6898.
10.	Surkan PJ, Malik A, Perin J, et al. Anxiety-focused cognitive behavioral therapy delivered by non-specialists to prevent postnatal depression: a randomized, phase 3 trial. Nat Med, 2024, 30(3): 675-682.
11.	Nishi D, Imamura K, Watanabe K, et al. The preventive effect of internet-based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period (iPDP): a large scale randomized controlled trial. Psychiatry Clin Neurosci, 2022, 76(11): 570-578.
12.	Loughnan SA, Butler C, Sie AA, et al. A randomised controlled trial of 'MUMentum postnatal': internet-delivered cognitive behavioural therapy for anxiety and depression in postpartum women. Behav Res Ther, 2019 May: 116: 94-103.
13.	Husain N, Lunat F, Lovell K, et al. Efficacy of a culturally adapted, cognitive behavioural therapy-based intervention for postnatal depression in British South Asian women (ROSHNI-2): a multicentre, randomised controlled trial. Lancet, 2024, 404(10461): 1430-1443.
14.	寧秋芬. 認知行為治療預防初產婦產后抑郁癥的隨機對照研究. 山西職工醫學院學報, 2018, 28(4): 48-49.
15.	張文霞, 張翠紅. 產后抑郁癥認知行為治療效果研究. 中國民康醫學, 2013, 25(15): 7-9.
16.	梁珊, 于騰飛, 程文紅. 產后抑郁與母嬰互動質量受損及早期干預. 中國臨床心理學雜志, 2020, 28(2): 395-399.
17.	Stewart AL, Payne JL. Perinatal depression: a review and an update. Psychiatr Clin North Am, 2023, 46(3): 447-461.
18.	Huang L, Zhao Y, Qiang C, et al. Is cognitive behavioral therapy a better choice for women with postnatal depression: a systematic review and meta-analysis. PLoS One, 2018, 13(10): e0205243.
19.	Li X, Laplante DP, Paquin V, et al. Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: a systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev, 2022, 92: 102129.
20.	Guo X, Guo X, Wang R, et al. Effects of perinatal cognitive behavioral therapy on delivery mode, fetal outcome, and postpartum depression and anxiety in women. Comput Math Methods Med, 2022, 2022: 8304405.
21.	Hofmann SG, Asnaani A, Vonk IJ, et al. The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognit Ther Res, 2012, 36(5): 427-440.
22.	Furukawa TA, Tajika A, Toyomoto R, et al. Cognitive behavioral therapy skills via a smartphone app for subthreshold depression among adults in the community: the RESiLIENT randomized controlled trial. Nat Med, 2025, 31(6): 1830-1839.
23.	Jannati N, Mazhari S, Ahmadian L, et al. Effectiveness of an app-based cognitive behavioral therapy program for postpartum depression in primary care: a randomized controlled trial. Int J Med Inform, 2020, 141: 104145.
24.	Bai P. Application and mechanisms of internet-based cognitive behavioral therapy (iCBT) in improving psychological state in cancer patients. J Cancer, 2023, 14(11): 1981-2000.

1. Gedzyk-Nieman SA. Postpartum and paternal postnatal depression: identification, risks, and resources. Nurs Clin North Am, 2021, 56(3): 325-343.
2. Kroska EB, Stowe ZN. Postpartum depression: identification and treatment in the clinic setting. Obstet Gynecol Clin North Am, 2020, 47(3): 409-419.
3. 肖意蘋, 張烜, 毛芳香, 等. 母親產后抑郁癥狀對嬰兒忽視的影響: 基于群體和個體視角的證據. 軍事護理, 2023, 40(7): 29-33.
4. Wang Z, Liu J, Shuai H, et al. Mapping global prevalence of depression among postpartum women. Transl Psychiatry, 2021, 11(1): 543.
5. Nakao M, Shirotsuki K, Sugaya N. Cognitive-behavioral therapy for management of mental health and stress-related disorders: recent advances in techniques and technologies. Biopsychosoc Med, 2021, 15(1): 16.
6. Hertenstein E, Trinca E, Wunderlin M, et al. Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: a systematic review and meta-analysis. Sleep Med Rev, 2022, 62: 101597.
7. Qin X, Liu C, Zhu W, et al. Preventing postpartum depression in the early postpartum period using an app-based cognitive behavioral therapy program: a pilot randomized controlled study. Int J Environ Res Public Health, 2022, 19(24): 16824.
8. Van Lieshout RJ, Layton H, Savoy CD, et al. Public health nurse-delivered group cognitive behavioural therapy for postpartum depression: a randomized controlled trial. Can J Psychiatry, 2022, 67(6): 432-440.
9. Van Lieshout RJ, Layton H, Savoy CD, et al. In-person 1-day cognitive behavioral therapy-based workshops for postpartum depression: a randomized controlled trial. Psychol Med, 2023, 53(14): 6888-6898.
10. Surkan PJ, Malik A, Perin J, et al. Anxiety-focused cognitive behavioral therapy delivered by non-specialists to prevent postnatal depression: a randomized, phase 3 trial. Nat Med, 2024, 30(3): 675-682.
11. Nishi D, Imamura K, Watanabe K, et al. The preventive effect of internet-based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period (iPDP): a large scale randomized controlled trial. Psychiatry Clin Neurosci, 2022, 76(11): 570-578.
12. Loughnan SA, Butler C, Sie AA, et al. A randomised controlled trial of 'MUMentum postnatal': internet-delivered cognitive behavioural therapy for anxiety and depression in postpartum women. Behav Res Ther, 2019 May: 116: 94-103.
13. Husain N, Lunat F, Lovell K, et al. Efficacy of a culturally adapted, cognitive behavioural therapy-based intervention for postnatal depression in British South Asian women (ROSHNI-2): a multicentre, randomised controlled trial. Lancet, 2024, 404(10461): 1430-1443.
14. 寧秋芬. 認知行為治療預防初產婦產后抑郁癥的隨機對照研究. 山西職工醫學院學報, 2018, 28(4): 48-49.
15. 張文霞, 張翠紅. 產后抑郁癥認知行為治療效果研究. 中國民康醫學, 2013, 25(15): 7-9.
16. 梁珊, 于騰飛, 程文紅. 產后抑郁與母嬰互動質量受損及早期干預. 中國臨床心理學雜志, 2020, 28(2): 395-399.
17. Stewart AL, Payne JL. Perinatal depression: a review and an update. Psychiatr Clin North Am, 2023, 46(3): 447-461.
18. Huang L, Zhao Y, Qiang C, et al. Is cognitive behavioral therapy a better choice for women with postnatal depression: a systematic review and meta-analysis. PLoS One, 2018, 13(10): e0205243.
19. Li X, Laplante DP, Paquin V, et al. Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: a systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev, 2022, 92: 102129.
20. Guo X, Guo X, Wang R, et al. Effects of perinatal cognitive behavioral therapy on delivery mode, fetal outcome, and postpartum depression and anxiety in women. Comput Math Methods Med, 2022, 2022: 8304405.
21. Hofmann SG, Asnaani A, Vonk IJ, et al. The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognit Ther Res, 2012, 36(5): 427-440.
22. Furukawa TA, Tajika A, Toyomoto R, et al. Cognitive behavioral therapy skills via a smartphone app for subthreshold depression among adults in the community: the RESiLIENT randomized controlled trial. Nat Med, 2025, 31(6): 1830-1839.
23. Jannati N, Mazhari S, Ahmadian L, et al. Effectiveness of an app-based cognitive behavioral therapy program for postpartum depression in primary care: a randomized controlled trial. Int J Med Inform, 2020, 141: 104145.
24. Bai P. Application and mechanisms of internet-based cognitive behavioral therapy (iCBT) in improving psychological state in cancer patients. J Cancer, 2023, 14(11): 1981-2000.

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Preventive and improvement effects of cognitive-behavioral therapy on postpartum depression: a meta-analysis

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