During the COVID-19 pandemic, pregnant women experienced elevated psychological distress while access to routine mental health services was often interrupted. This systematic review sought to summarize psychological interventions implemented during pregnancy in the pandemic context and to evaluate their effectiveness in reducing distress and in enhancing resilience.
The authors performed a systematic search of four databases, with the search period covering literature up to 3 September 2025. Both randomized and non-randomized studies were eligible if they evaluated psychological interventions delivered during pregnancy in the context of the pandemic. Sixteen studies ultimately met the inclusion criteria and were synthesized in the review.
Included studies tested a range of psychological approaches. Reported intervention types comprised cognitive behavioural therapy (CBT), mindfulness-based interventions, psychoeducation, and various other psychological methods. The review grouped these approaches to assess whether psychological support adapted to pandemic conditions could alleviate common perinatal mental health problems.
Intervention delivery was diverse across the included studies. Modes described in the review included individual therapy, group-based programs, purely digital interventions, and hybrid models combining remote and in-person elements. The adaptation of interventions to digital or hybrid formats was emphasized as a practical response to pandemic-related restrictions and reduced availability of in-person services.
Most studies included in the review reported reductions in measures of depression, anxiety, or stress following the psychological interventions. Several studies also reported improvements in factors related to resilience, suggesting potential benefits beyond symptom reduction. The review presents these findings as indicative that psychological interventions, when adapted for pandemic conditions, can positively affect maternal emotional well-being during pregnancy.
The review notes that overall methodological quality across studies was modest. Studies varied substantially in design, outcome measures, and assessment timing, which limited comparability. Outcome measures were heterogeneous, and few studies included longer-term follow-up. These limitations constrain firm conclusions about the magnitude and durability of intervention effects and highlight the need for standardized measurement and improved study design in future work.
Findings from the review suggest that accessible, scalable psychological interventions—particularly those adapted for digital or hybrid delivery—may serve as viable strategies to support maternal mental health when routine care pathways are disrupted by crises such as a pandemic. The diversity of intervention types and delivery modes indicates multiple feasible options for service adaptation, including remote CBT, mindfulness training, and psychoeducational programs tailored for pregnant populations.
The authors recommend that future research prioritize larger, methodologically rigorous trials that use standardized outcome measures and include longer follow-up periods. Such trials would strengthen the evidence base concerning which intervention types and delivery formats are most effective and sustainable for improving maternal mental health and resilience during crises. The review emphasizes the need for confirmatory studies to evaluate effectiveness, scalability, and longer-term benefits.
This systematic review of interventions delivered during pregnancy in the COVID-19 pandemic identified 16 studies evaluating psychological approaches including CBT, mindfulness, and psychoeducation across individual, group, digital, and hybrid formats. Most studies reported reductions in depression, anxiety, or stress, and some reported gains in resilience-related outcomes. However, modest methodological quality, heterogeneity of outcomes, and limited follow-up restrict strong conclusions. Interventions adapted for digital or hybrid delivery show promise for maintaining and improving maternal emotional well-being in times of crisis, and the review calls for more robust, standardized, and longer-term research to guide clinical implementation.