The Impact of Online Mindfulness Interventions on Postpartum Depression: A Systematic Review and Meta-Analysis

Postpartum depression is a significant global public health issue, with serious maternal and neonatal consequences. Online mindfulness interventions provide a promising alternative, offering flexible and low-risk support that overcomes barriers like stigma and accessibility. This review aimed to assess the effects of online mindfulness interventions on postpartum depression, anxiety, and stress symptoms. We searched databases including PubMed, Web of Science, Scopus, ClinicalTrials, Cochrane Library, CINAHL, PsycINFO, ProQuest, Embase, CNKI, Wanfang, VIP, and Sinomed. The search was limited to randomised controlled trials published up to December 31, 2024. Study quality was assessed using the Cochrane Handbook 5.1.0 tool. Depression scores were analysed using standardised mean differences (SMD) with 95% confidence intervals (CIs). A total of 2560 papers were found, and of these, 23 studies including 2725 participants across eight countries, met the inclusion criteria and were meta-analysed. Meta-analysis results showed that online mindfulness interventions significantly improved depression in postpartum women, both in the short term (SMD = -0.53, 95% CI [-0.72, -0.34], p < 0.05) and in the long term (SMD = -0.53, 95% CI [-0.82, -0.23], p < 0.05). Anxiety symptoms were also significantly improved (SMD = -0.36, 95% CI [-0.58, -0.14], p < 0.05). Stress symptoms were not significantly improved (SMD = -0.16, 95% CI [-0.43, 0.10], p > 0.05). Greater effects were observed for interventions delivered via text messages and online face-to-face formats. Interventions involving additional researcher support and those with complex mindfulness components were also more effective (p < 0.05). A 5-8-week intervention period showed the most stable effects (p < 0.05). The follow-up dropout rate was similar between the intervention and control groups (RR = 0.98, 95% CI [0.96, 1.01]). Future studies should further explore the long-term effects of these interventions.