Modifiers of effectiveness and deterioration, and prognostic factors of adherence in internet-based interventions for treatment of perinatal depression: A systematic review and individual participant data meta-analysis.

Authors

Marketa Ciharova, Pim Cuijpers, Mathias Harrer, Yafit Hirshler, Olga-Maria Panagiotopoulou, Lingyao Tong, Clara Miguel, Iryna Frankova, Alan W Gemmill, Claudia Buntrock, Wouter van Ballegooijen, Ana Fonseca, Mariana Branquinho, Erik Forsell, Nicole E Pugh, Heather D Hadjistavropoulos, Yaoyao Sun, Pamela Franco, Carlos Barquero-Jiménez, Irene Gómez-Gómez, Emma Motrico, Pedro Fonseca Zuccolo, Daniel Fatori, Jeannette Milgrom, Eirini Karyotaki

Published in

Internet interventions. Volume 46. Pages 100993. Epub Sep 03, 2026.

Abstract

Internet-based interventions for perinatal depression reduce depressive symptoms in new and expectant mothers. However, modifiers of their effects, and prognostic factors of adherence, are unknown.
To assess modifiers of effectiveness and deterioration, and prognostic factors of adherence in internet-based interventions for perinatal depression.
Systematic searches were conducted in three bibliographic databases on February 7, 2025. Two independent researchers identified randomized controlled trials (RCTs) of internet-based interventions for perinatal depression. We conducted conventional and two-stage individual participant data meta-analysis (IPDMA).
Eighteen studies were eligible, and data from nine (n = 1094 participants) were pooled in IPDMA. We found evidence of a difference in post-treatment depressive symptoms between participants in the internet-based intervention and controls (SMD = 0.29 [95%CI: 0.03-0.54], small effect size), increase in response (RR = 1.97 [95%CI: 1.57-2.47]) and remission (RR = 1.73 [95%CI: 1.38-2.18]). The interventions were effective for anxiety symptoms (SMD = 0.26 [95%CI: 0.11-0.40]) but not for reliable deterioration (OR = 0.80 [95%CI: 0.49-1.32]). No modifiers of effectiveness or deterioration, or prognostic factors of adherence were identified. Baseline depressive symptoms and comorbid anxiety were prognostic factors for higher depressive symptoms at post-treatment.
Internet-based interventions for perinatal depression are effective for depressive and anxiety symptoms in new and expectant mothers. They may be offered to patients regardless of their age, education, relationship status, employment, baseline depressive or anxiety symptoms, previous treatment, number of children, or ethnic minority status, if they wish to follow them. RCTs should collect more information on factors relevant to the perinatal period, such as partner's mental health and pregnancy complications.
Open Science Framework (https://osf.io/98tms).

PMID:
42733546
Bibliographic data and abstract were imported from PubMed on 14 Sep 2026.

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