Non-pharmacological interventions for perinatal parental depression and anxiety: a systematic review and network meta-analysis.

Background

Perinatal depression and anxiety exhibit significant partner interdependence and family-level ramifications, constituting a family issue concerning both parents. However, existing evidence syntheses have predominantly examined maternal or paternal mental health in isolation, neglecting the systemic integrity of the family unit.

Objective

To conduct the first Bayesian network meta-analysis to evaluate and rank non-pharmacological interventions delivered concurrently to both parents for perinatal depression and anxiety.

Methods

Seven databases were searched from inception to May 30, 2025. We included randomized controlled trials (RCTs) in which both perinatal parents received the same non-pharmacological intervention and depression or anxiety was assessed. A Bayesian network meta-analysis was conducted following PRISMA guidelines. PROSPERO CRD420251048539.

Results

We included 36 RCTs involving 15,477 parents (51.8% mothers and 48.2% fathers/partners). For depression, multicomponent interventions (SMD = -0.34, 95% CrI [-0.60, -0.08]; SUCRA = 79.86%) and psychosocial interventions (SMD = -0.25, 95% CrI [-0.43, -0.07]; SUCRA = 60.83%) showed beneficial estimates. For anxiety, multicomponent interventions (SMD = -0.48, 95% CrI [-0.66, -0.29]; SUCRA = 98.12%) and parent-child interaction interventions (SMD = -0.19, 95% CrI [-0.36, -0.03]; SUCRA = 62.69%) showed beneficial estimates. Certainty of evidence ranged from low to moderate.

Conclusion

Multicomponent interventions may be preferred across both symptom domains, while parent-child interaction and psychosocial interventions may offer symptom-specific benefits. Because the networks were sparse, comparisons were predominantly indirect, heterogeneity was substantial, and evidence certainty was low to moderate, these findings are provisional. They support family-centered care involving both parents and require further rigorous head-to-head trials.