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已发表论文
产后抑郁和焦虑非药物干预措施的比较效果：一项网络荟萃分析
Authors Zhu Y , Yang W, Li N , Yang J, Yang J, Zheng Y, Chen W, Yang Y, Liu Y , Zhao Y
Received 1 July 2025
Accepted for publication 18 November 2025
Published 16 December 2025 Volume 2025:21 Pages 2817—2834
DOI https://doi.org/10.2147/NDT.S549504
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Roger Pinder
Yuqin Zhu,1,* Weicheng Yang,1,* Na Li,2 Jinfeng Yang,1 Jinqi Yang,1 Yan Zheng,1 Wen Chen,1 Yunchang Yang,1 Yunlu Liu,1 Yan Zhao1
1Sports Medicine Key Laboratory of Sichuan Province, School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China; 2The National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yunlu Liu, Sports Medicine Key Laboratory of Sichuan Province, School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China, Email kaela85@qq.com Yan Zhao, Sports Medicine Key Laboratory of Sichuan Province, School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China, Email miniezy@126.com
Background: Postpartum depression (PPD), a prevalent perinatal mood disorder characterized by persistent depressive and anxiety symptoms, significantly impacts maternal-infant health. The COVID-19 pandemic has further increased the global burden of PPD, emphasizing the need for effective and accessible interventions. Although non-pharmacological interventions are widely used, their comparative efficacy remains uncertain.
Methods: We searched the Cochrane Library, Web of Science, EMBASE, PubMed, Scopus, CNKI, VIP Database, and Wanfang Database (inception to September 1, 2024) for randomized controlled trials (RCTs). Interventions included acupuncture (ACU), exercise (EXE), psychotherapy (PSY), exercise combined with psychotherapy (ECP), and music therapy (MT). Primary (depression) and secondary (anxiety) outcomes were pooled using mean differences (MD) with 95% credible intervals (CrI). Risk of bias was assessed via Cochrane RoB2. (PROSPERO: CRD42020166801).
Results: Thirty-five RCTs were included (n=4047). Meta-analyses for depressive symptoms (5 interventions, n=4047) showed a statistically significant improvement in the non-pharmacological intervention group compared with the control group (standard care, no intervention, or placebo et al), particularly for the ECP (95% CrI − 2.3 to − 0.85), followed by ACU (95% CrI − 1.8 to − 0.44) and EXE (95% CrI − 1.7 to − 0.48). Similarly, for anxiety symptoms (5 interventions, n=863), the overall effect of the non-pharmacological interventions was superior to that of the control group, with ECP again being the most effective modality (95% CrI − 2.3 to − 0.18), followed by EXE (95% CrI − 2.0 to − 0.0021) and ACU (95% CrI − 0.96 to − 0.052).
Conclusion: This study demonstrates the promise of non-pharmacological interventions, particularly exercise, acupuncture, and ECP, for alleviating PPD symptoms, positioning ECP as a potential first-line intervention for mild to moderate cases.
Keywords: postpartum depression, anxiety, network meta-analysis, non-pharmacological intervention
1Sports Medicine Key Laboratory of Sichuan Province, School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China; 2The National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yunlu Liu, Sports Medicine Key Laboratory of Sichuan Province, School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China, Email kaela85@qq.com Yan Zhao, Sports Medicine Key Laboratory of Sichuan Province, School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, People’s Republic of China, Email miniezy@126.com
Background: Postpartum depression (PPD), a prevalent perinatal mood disorder characterized by persistent depressive and anxiety symptoms, significantly impacts maternal-infant health. The COVID-19 pandemic has further increased the global burden of PPD, emphasizing the need for effective and accessible interventions. Although non-pharmacological interventions are widely used, their comparative efficacy remains uncertain.
Methods: We searched the Cochrane Library, Web of Science, EMBASE, PubMed, Scopus, CNKI, VIP Database, and Wanfang Database (inception to September 1, 2024) for randomized controlled trials (RCTs). Interventions included acupuncture (ACU), exercise (EXE), psychotherapy (PSY), exercise combined with psychotherapy (ECP), and music therapy (MT). Primary (depression) and secondary (anxiety) outcomes were pooled using mean differences (MD) with 95% credible intervals (CrI). Risk of bias was assessed via Cochrane RoB2. (PROSPERO: CRD42020166801).
Results: Thirty-five RCTs were included (n=4047). Meta-analyses for depressive symptoms (5 interventions, n=4047) showed a statistically significant improvement in the non-pharmacological intervention group compared with the control group (standard care, no intervention, or placebo et al), particularly for the ECP (95% CrI − 2.3 to − 0.85), followed by ACU (95% CrI − 1.8 to − 0.44) and EXE (95% CrI − 1.7 to − 0.48). Similarly, for anxiety symptoms (5 interventions, n=863), the overall effect of the non-pharmacological interventions was superior to that of the control group, with ECP again being the most effective modality (95% CrI − 2.3 to − 0.18), followed by EXE (95% CrI − 2.0 to − 0.0021) and ACU (95% CrI − 0.96 to − 0.052).
Conclusion: This study demonstrates the promise of non-pharmacological interventions, particularly exercise, acupuncture, and ECP, for alleviating PPD symptoms, positioning ECP as a potential first-line intervention for mild to moderate cases.
Keywords: postpartum depression, anxiety, network meta-analysis, non-pharmacological intervention