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Review
. 2025 Mar 21;13(7):696.
doi: 10.3390/healthcare13070696.

The Effects of Online Cognitive Behavioral Therapy on Postpartum Depression: A Systematic Review and Meta-Analysis

Jingyu Pan  1 , Wenjing Luo  1 , Haijuan Zhang  2   3   4   5 , Yong Wang  2   3   4   5 , Hong Lu  1 , Chongkun Wang  1 , Chunying Li  6 , Li Fu  7 , Yinchu Hu  1 , Yuxuan Li  8 , Meidi Shen  1
Affiliations
Review

The Effects of Online Cognitive Behavioral Therapy on Postpartum Depression: A Systematic Review and Meta-Analysis

Jingyu Pan et al. Healthcare (Basel). .

Abstract

Background/objectives: Postpartum depression seriously affects the safety and health of mothers and children. Online cognitive behavioral therapy is considered to be a promising treatment; however, whether it is effective at improving postpartum depression is inconsistent and the specific intervention measures are not the same. The objectives of this study were to comprehensively review the effects of online cognitive behavioral therapy on postpartum depression and further explore the specific intervention measures.

Methods: A literature search was conducted using thirteen electronic databases and two clinical trial registries from the establishment of the databases to 31 December 2023. The study selection and data extraction were independently performed by two researchers. The latest Cochrane Risk of Bias tool was selected to evaluate the quality of the included studies. Data were analyzed using Review Manager 5.4, and the certainty of the evidence was evaluated using the online GRADEpro tool. Eighteen studies involving 3689 women were included.

Results: The results showed that online cognitive behavioral therapy was effective at improving postpartum depression. A subgroup analysis showed that the duration of online cognitive behavioral therapy with total intervention was 9 weeks and above, the total intervention number was 12 times or fewer, and using a website or Zoom online conference room as the intervention platform could more significantly improve postpartum depression. In particular, providing professional guidance could be more effective.

Conclusions: In summary, online cognitive behavioral therapy was effective for postpartum depression. Furthermore, this study found out how specific intervention measures of online cognitive behavioral therapy could be more effective. Finally, nurses can participate in the therapy to improve access to evidence-based treatment.

Keywords: cognitive behavioral therapy; meta-analysis; online; postpartum depression; systematic review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The PRISMA flow diagram. * represents the total number of records identified from databases and registers.
Figure 2
Figure 2
Summary of risk of bias for the eighteen studies included [17,18,21,22,24,25,26,27,28,29,30,31,34,35,36,37,38,39].
Figure 3
Figure 3
Forest plot of the effect of online cognitive behavioral therapy (OCBT) on postpartum depression symptoms [17,21,22,24,25,26,27,28,29,30,31,34,35,36,37,38].
Figure 4
Figure 4
Forest plot of the effect of OCBT on postpartum depression symptoms for different cultures [17,21,22,24,25,26,27,28,29,30,31,34,35,36,37,38].
Figure 5
Figure 5
Forest plot of the effect of OCBT on postpartum depression symptoms for different intervention durations [17,21,22,24,25,26,27,28,29,30,31,34,35,36,37,38].
Figure 6
Figure 6
Forest plot of the effect of OCBT on postpartum depression symptoms for different intervention numbers [17,21,24,25,26,27,28,29,30,31,34,35,36,37,38].
Figure 7
Figure 7
Forest plot of the effect of OCBT on postpartum depression symptoms for different intervention platforms [17,21,22,24,25,26,27,28,29,30,31,34,35,36,37,38].
Figure 8
Figure 8
Forest plot of the effect of OCBT on postpartum depression symptoms for different intervention guidance methods [17,21,22,24,25,26,27,28,29,30,31,34,35,36,37,38].
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