Effects of different mind-body interventions for pregnant women on mental health: A systematic review and network meta-analysis of randomized controlled trials

BACKGROUND: Maternal mental health is a key determinant of maternal well-being, fetal development, and family harmony. Although various antenatal mental health interventions exist, their comparative efficacy needs further investigation. AIM: To evaluate Mindfulness-Based Childbirth and Parenting (MBCP), Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), Cognitive-Behavioral Therapy (CBT), Music, and Yoga on maternal mental health outcomes to guide targeted intervention strategies. METHODS: A systematic search of PubMed, Web of Science, Cochrane Library, Embase, Science Direct, and Medline was conducted from inception to May 1, 2025, to identify RCTs on six mind-body interventions in pregnant women. The primary outcome was depression and anxiety. The secondary outcomes were stress, pain, mindfulness, and self-efficacy. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and was registered in PROSPERO (CRD420251030950). RESULTS: Fifty-three RCTs (n = 10,167) were included. Compared with the control group, MBSR showed a significant reduction in depression [SUCRA = 93.07%, SMD = -1.66, 95%CI = (-2.25, -1.07)], anxiety [SUCRA = 87.79%, SMD = -1.94, 95%CI = (-2.77, -1.12)], and stress [SUCRA = 88.3%, SMD = -2.03, 95%CI = (-2.66, -1.40)]. Yoga showed significantly reducing on pain [SUCRA = 66.03%, SMD = -0.79, 95%CI = (-1.24, -0.35)] and enhancing self-efficacy [SUCRA = 80.13%, SMD = 0.85, 95%CI = (0.34, 1.37)]. MBCP showed a significant improvement in mindfulness [SUCRA = 87.10%, SMD = 0.72, 95%CI = (-0.15, 1.59)]. CONCLUSION: Different mind-body interventions may be associated with improvements in specific outcome domains. MBSR showed more consistent associations with reductions in depressive, anxiety, and stress, whereas yoga was more commonly associated with improvements in pain and self-efficacy, and MBCP with mindfulness. These findings should be interpreted cautiously given limited sample sizes and the lack of direct comparisons.