Internet-Based Cognitive Behavioral Therapy for Preventing Postpartum Depressive Symptoms Among Pregnant Individuals With Depression: Multicenter Randomized Controlled Trial in China

Bibliographic Details
Title: Internet-Based Cognitive Behavioral Therapy for Preventing Postpartum Depressive Symptoms Among Pregnant Individuals With Depression: Multicenter Randomized Controlled Trial in China
Authors: Chen-Chi Duan, Chen Zhang, Hua-Lin Xu, Jing Tao, Jia-Le Yu, Dan Zhang, Shan Wu, Xiu Zeng, Wan-Ting Zeng, Zhi-Yin Zhang, Cindy-Lee Dennis, Han Liu, Jia-Ying Wu, Ben Willem J Mol, He-Feng Huang, Yan-Ting Wu
Source: Journal of Medical Internet Research, Vol 27, p e67386 (2025)
Publisher Information: JMIR Publications, 2025.
Publication Year: 2025
Collection: LCC:Computer applications to medicine. Medical informatics
LCC:Public aspects of medicine
Subject Terms: Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
More Details: BackgroundWomen are particularly vulnerable to depression during pregnancy, which is one of the strongest risk factors for developing postpartum depression (PPD). Addressing antenatal depressive symptoms in these women is crucial for preventing PPD. However, little is known about the effectiveness of internet-based cognitive behavioral therapy (ICBT) in preventing PPD in this high-risk group. ObjectiveThis study aims to evaluate the short- and long-term effects of ICBT in preventing PPD among women with antenatal depressive symptoms. MethodsParticipants were screened for antenatal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) and randomly allocated (1:1) to either the ICBT group (receiving weekly online modules starting antenatally and continuing into early postpartum) or the control group (observed without treatment). Follow-up assessments were conducted up to 12 months postpartum, and data were analyzed using generalized estimating equations. The primary outcome was the prevalence of depressive symptoms at 6 weeks postpartum. A subgroup analysis based on the severity of antenatal depressive symptoms was also performed. The secondary outcomes included the long-term effects of ICBT on maternal depression, as well as its impact on anxiety, sleep quality, social support, parenting stress, co-parenting relationships, and infant development. ResultsBetween August 2020 and September 2021, 300 pregnant individuals were recruited from 5 centers across China. No significant differences were observed in depressive symptoms at 6 weeks postpartum (P=.18) or at any longer-term follow-up time points (P=.18). However, a post hoc subgroup analysis showed that participants with antenatal EPDS scores of 10-12 in the ICBT group had a lower risk of developing depression during the first year postpartum (odds ratio 0.534, 95% CI 0.313-0.912; P=.02), but this was not observed for participants with more severe depression. Additionally, this subgroup demonstrated higher levels of co-parenting relationships (P=.02). ConclusionsAmong individuals with antenatal depression, ICBT did not prevent the development of PPD. However, ICBT may be a preferable option for those with mild to moderate antenatal depressive symptoms. Future research is needed to explore modifications to ICBT to address more severe depressive symptoms. Trial RegistrationChinese Clinical Trial Registry ChiCTR2000033433; https://www.chictr.org.cn/showproj.html?proj=54482 International Registered Report Identifier (IRRID)RR2-10.1186/s13063-022-06728-5
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1438-8871
Relation: https://www.jmir.org/2025/1/e67386; https://doaj.org/toc/1438-8871
DOI: 10.2196/67386
Access URL: https://doaj.org/article/e1124468e0d34619a2a2d38a9143d25a
Accession Number: edsdoj.1124468e0d34619a2a2d38a9143d25a
Database: Directory of Open Access Journals
More Details
ISSN:14388871
DOI:10.2196/67386
Published in:Journal of Medical Internet Research
Language:English