Internet-delivered psychological interventions for clinical anxiety and depression in perinatal women: a systematic review and meta-analysis

  • Siobhan A. LoughnanEmail author
  • Amy E. Joubert
  • Ashlee Grierson
  • Gavin Andrews
  • Jill M. Newby
Review Article


Perinatal anxiety and depression are common and associated with negative outcomes if left untreated. Internet-delivered treatments can improve treatment accessibility and have demonstrated effectiveness in treating anxiety and depression in the general adult population. However, little is known about how effective and acceptable these interventions are for perinatal women. This paper describes a systematic review and preliminary meta-analysis of internet-delivered psychological interventions for the treatment of clinical anxiety and depression in perinatal women. A systematic search was carried out of seven electronic databases. Seven studies evaluating six distinct internet-delivered psychological interventions were identified. Of the seven studies included, two were open trials and five were randomized controlled trials with a total of 595 participants. Preliminary findings indicate large improvements in depression (Hedges g = 1.67; 95% CI 1.38–1.96) and anxiety (Hedges g = 1.08; 95% CI 0.80–1.36) from pre- to post-treatment. However, between-group differences between interventions and control conditions were only moderate for depression (Hedges g = 0.60; 95% CI 0.43–0.78) and anxiety (Hedges g = 0.54; 95% CI 0.24–0.85). While our preliminary findings are promising, this review identifies an area of research still in its early stages with significant gaps in the literature that need to be addressed. Further research is needed to establish the efficacy and acceptability of these interventions in this population, especially for antenatal depression and anxiety disorders.


Pregnancy Postpartum Anxiety Depression Internet 


Authors’ contributions

SL, JN, and GA designed the study and wrote the protocol and search strategy. SL, AJ, and AG conducted the searches, screened the titles, abstracts, and full-texts for eligibility for inclusion into the meta-analysis, and coded the risk of bias of all RCTs. SL extracted the data from the manuscripts, independently checked by AJ, and conducted the data analysis with supervision from JN. All authors contributed to and have approved the final version of the manuscript for publication.


This study was supported by the Australian Rotary Health and the David Henning Memorial Foundation in the form of a Ph.D. scholarship awarded to Siobhan Loughnan. Jill Newby is supported by an Australian National Health and Medical Research Council (NHMRC)/Medical Research Future Fund Career Development Fellowship (1145382).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Protocol and registration

The protocol for this systematic review was developed according to the Cochrane Handbook for Systematic Reviews of Interventions (Higgins and Green 2011) and was registered with PROSPERO [CRD42016038032]. All reporting of this systematic review follows the PRISMA guidelines (Moher et al. 2009).


NHMRC, Rotary Health Australia, and the David Henning Memorial Foundation had no role in the study design, collection, data analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Siobhan A. Loughnan
    • 1
    • 2
    Email author
  • Amy E. Joubert
    • 1
    • 3
  • Ashlee Grierson
    • 1
    • 2
  • Gavin Andrews
    • 1
    • 2
  • Jill M. Newby
    • 1
    • 3
  1. 1.Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry, Level 4O’Brien Centre, St Vincent’s HospitalSydneyAustralia
  2. 2.School of PsychiatryUniversity of New South WalesSydneyAustralia
  3. 3.School of PsychologyUniversity of New South WalesSydneyAustralia

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