Efectividad de la Psicoterapia durante el Embarazo: Revisión Sistemática de Resultados Maternos, Obstétricos y Neonatales
Palabras clave:
psicoterapia prenatal, depresión gestacional, ansiedad en el embarazo, desenlaces obstétricos, desenlaces neonatales
Resumen
La salud mental durante el embarazo influye directamente sobre el bienestar materno y los desenlaces perinatales. Los trastornos depresivos y de ansiedad afectan al 10-20% de las gestantes y permanecen frecuentemente subdiagnosticados y subtratados (Howard et al., 2014). Analizar en qué medida las intervenciones psicoterapéuticas aplicadas durante la gestación, frente a la atención convencional u otras condiciones activas de comparación, influyen en la salud mental materna y en los desenlaces relacionados con el parto y el recién nacido. Revisión sistemática conforme a PRISMA 2020 (Page et al., 2021). Búsqueda en PubMed con descriptores MeSH (2000-2026). Se incluyeron ensayos controlados aleatorizados (ECA), estudios cuasiexperimentales y cohortes comparativas. Calidad metodológica evaluada con listas JBI. La heterogeneidad clínica y metodológica impidió el metaanálisis formal.Se incluyeron 22 estudios con más de 3.500 participantes en 10 países. La terapia cognitivo-conductual (TCC), la psicoterapia interpersonal (IPT) y las intervenciones basadas en mindfulness redujeron significativamente los síntomas depresivos y ansiosos en 19 de los 22 estudios. Los desenlaces obstétricos y neonatales mostraron resultados heterogéneos, sin diferencias significativas en la mayoría de los análisis por intención de tratar. La psicoterapia prenatal tiene un efecto positivo robusto sobre la salud mental materna. La evidencia sobre desenlaces obstétricos y neonatales es limitada e inconsistente, representando el principal vacío en la investigación perinatal actual.
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Bayat, A., Amiri-Farahani, L., Soleimani, M., Eshraghi, N., y Haghani, S. (2021). Effect of short-term psychological intervention on anxiety of pregnant women with positive screening results for chromosomal disorders: A randomized controlled trial. BMC Pregnancy and Childbirth, 21(1), 757. https://doi.org/10.1186/s12884-021-04206-5
Dimidjian, S., Goodman, S. H., Felder, J. N., Gallop, R., Brown, A. K., y Beck, A. (2016). Staying well during pregnancy and after childbirth: A pilot randomized clinical trial of mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 84(2), 134-145. https://doi.org/10.1037/ccp0000068
Duan, C. C., et al. (2025). Internet-based cognitive behavioral therapy for preventing postpartum depressive symptoms among pregnant individuals with depression: Multicenter RCT in China. Journal of Medical Internet Research, 27, e67386. https://doi.org/10.2196/67386
Evans, K., Morrell, C. J., y Spiby, H. (2018). Non-pharmacological interventions to reduce symptoms of mild to moderate anxiety in pregnant women: Systematic review. Journal of Advanced Nursing, 74(2), 289-309. https://doi.org/10.1111/jan.13422
Felder, J. N., Epel, E. S., Neuhaus, J., Krystal, A. D., y Prather, A. A. (2020). Efficacy of digital CBT for the treatment of insomnia symptoms among pregnant women: A randomized clinical trial. JAMA Psychiatry, 77(5), 484-492. https://doi.org/10.1001/jamapsychiatry.2019.4491
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., y Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 106(5 Pt 1), 1071-1083. https://doi.org/10.1097/01.AOG.0000183597.31630.db
Green, S. M., Donegan, E., McCabe, R. E., Streiner, D. L., Agako, A., y Frey, B. N. (2020). Cognitive behavioral therapy for perinatal anxiety: A randomized controlled trial. Australian & New Zealand Journal of Psychiatry, 54(4), 423-432. https://doi.org/10.1177/0004867419898528
Grote, N. K., et al. (2023). Effect of brief interpersonal therapy on depression during pregnancy: A randomized clinical trial. JAMA Psychiatry, 80(6), 539-547. https://doi.org/10.1001/jamapsychiatry.2023.0702
Howard, L. M., Molyneaux, E., Dennis, C. L., Rochat, T., Stein, A., y Milgrom, J. (2014). Non-psychotic mental disorders in the perinatal period. The Lancet, 384(9956), 1775-1788. https://doi.org/10.1016/S0140-6736(14)61276-9
Jimenez-Barragan, M., et al. (2025). Immersive virtual reality eHealth intervention to reduce anxiety and depression in pregnant women: Randomized controlled trial. JMIR Human Factors, 12, e71708. https://doi.org/10.2196/71708
Loughnan, S. A., et al. (2019). A randomized controlled trial of MUMentum Pregnancy: Internet-delivered CBT for antenatal anxiety and depression. Journal of Affective Disorders, 243, 381-390. https://doi.org/10.1016/j.jad.2018.09.057
Page, M. J., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Puertas-Gonzalez, J. A., Romero-Gonzalez, B., Mariño-Narvaez, C., Cruz-Martinez, M., y Peralta-Ramirez, M. I. (2021). La terapia cognitiva-conductual como amortiguadora de los efectos psicológicos negativos del confinamiento por la COVID-19 en mujeres embarazadas. Revista Española de Salud Pública, 95, e202103014.
Atzmon, O., Crowther, M. E., Quin, N., Cassera, L., Wellecke, C., Pinnington, D. M., y Bei, B. (2025). Cognitive behavioral therapy for perinatal insomnia: Exploring adherence, perceived usefulness of intervention components, and their associations with sleep outcomes. Behavioral Sleep Medicine, 23(5), 606-621. https://doi.org/10.1080/15402002.2025.2501704
Salehi, F., Pourasghar, M., Khalilian, A., y Shahhosseini, Z. (2016). Comparison of group CBT and interactive lectures in reducing anxiety during pregnancy. Medicine, 95(43), e5224. https://doi.org/10.1097/MD.0000000000005224
Siebach, K. F., Perin, J., Malik, A., Atif, N., Zaidi, A., Rahman, A., y Surkan, P. J. (2024a). Anxiety-focused CBT delivered by non-specialists to prevent postnatal depression: A randomized, phase 3 trial [NCT03880032]. Scientific Reports.
Siebach, K. F., Perin, J., Malik, A., Atif, N., Zaidi, A., Rahman, A., y Surkan, P. J. (2024b). Results of a CBT-based intervention for antenatal anxiety on birth outcomes in Pakistan: A randomized control trial. Scientific Reports, 14(1), 13806. https://doi.org/10.1038/s41598-024-64119-z
Sockol, L. E., Epperson, C. N., y Barber, J. P. (2015). A meta-analysis of cognitive behavioral therapy for adult perinatal depression. Psychotherapy and Psychosomatics, 84(1), 1-11. https://doi.org/10.1159/000366487
Spinelli, M. G., y Endicott, J. (2003). Controlled clinical trial of interpersonal psychotherapy versus parenting education program for depressed pregnant women. American Journal of Psychiatry, 160(3), 555-562. https://doi.org/10.1176/appi.ajp.160.3.555
Tomfohr-Madsen, L. M., Clayborne, Z. M., Rouleau, C. R., y Campbell, T. S. (2016). Sleeping for two: An open-pilot study of CBT-I in pregnancy. Behavioral Sleep Medicine, 15(5), 377-393. https://doi.org/10.1080/15402002.2016.1141769
Tufanaru, C., Munn, Z., Aromataris, E., Campbell, J., y Hopp, L. (2020). Chapter 3: Systematic reviews of effectiveness. En JBI Manual for Evidence Synthesis. JBI. https://doi.org/10.46658/JBIMES-20-04
Zarenejad, M., Yazdkhasti, M., Rahimzadeh, M., Mehdizadeh Tourzani, Z., y Esmaelzadeh-Saeieh, S. (2020). The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial. Brain and Behavior, 10(3), e01561. https://doi.org/10.1002/brb3.1561
Burns, A., O’Mahen, H., Baxter, H., Bennert, K., Wiles, N., Ramchandani, P., Turner, K., Sharp, D., Thorn, J., Noble, S., y Evans, J. (2013). A pilot randomised controlled trial of cognitive behavioural therapy for antenatal depression. BMC Psychiatry, 13, 33. https://doi.org/10.1186/1471-244X-13-33
Duncan, L. G., Cohn, M. A., Chao, M. T., Cook, J. G., Riccobono, J., y Bardacke, N. (2017). Benefits of preparing for childbirth with mindfulness training: A randomized controlled trial with active comparison. BMC Pregnancy and Childbirth, 17, 140. https://doi.org/10.1186/s12884-017-1319-3
Field, T., Diego, M., y Hernandez-Reif, M. (2010). Prenatal depression effects and interventions: A review. Infant Behavior and Development, 33(4), 409-418. https://doi.org/10.1016/j.infbeh.2010.04.005
Kaaya, S., Siril, H., Smith Fawzi, M. C., Aloyce, Z., Araya, R., Kaale, A., Kasmani, M. N., Komba, A., Minja, A., Mwimba, A., Ngakongwa, F., Somba, M., Sudfeld, C. R., y Larson, E. (2022). A peer-facilitated psychological group intervention for perinatal women living with HIV and depression in Tanzania—Healthy Options: A cluster-randomized controlled trial. PLoS Medicine, 19(12), e1004112. https://doi.org/10.1371/journal.pmed.1004112
Lenze, S. N., Potts, M. A., Rodgers, J., y Luby, J. (2020). Lessons learned from a pilot randomized controlled trial of dyadic interpersonal psychotherapy for perinatal depression in a low-income population. Journal of Affective Disorders, 271, 286-292. https://doi.org/10.1016/j.jad.2020.03.084
Shayan, A., Masoumi, S. Z., Shobeiri, F., y Kazemi, F. (2020). The effect of mindfulness-based counselling on the anxiety levels and childbirth satisfaction among primiparous pregnant women: A randomized controlled trial [IRCT20170305032900N3]. Iranian Journal of Nursing and Midwifery Research, 25(4), 339-344. https://doi.org/10.4103/ijnmr.IJNMR_264_19
Urizar, G. G. Jr., y Muñoz, R. F. (2011). Impact of a prenatal cognitive-behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants. Psychoneuroendocrinology, 36(10), 1480-1494. https://doi.org/10.1016/j.psyneuen.2011.04.002
Verbeek, T., Arjadi, R., Honig, A., Spinhoven, P., y Burger, H. (2017). Group-based multicomponent treatment to reduce depressive symptoms in women with co-morbid psychiatric and psychosocial problems during pregnancy: A randomized controlled trial. Journal of Affective Disorders, 228, 153-160. https://doi.org/10.1016/j.jad.2017.07.018
Woolhouse, H., Mercuri, K., Judd, F., y Brown, S. J. (2014). Antenatal mindfulness intervention to reduce depression, anxiety and stress: A pilot randomised controlled trial of the MindBabyBody program in an Australian tertiary maternity hospital. BMC Pregnancy and Childbirth, 14, 369. https://doi.org/10.1186/s12884-014-0369-z
Dimidjian, S., Goodman, S. H., Felder, J. N., Gallop, R., Brown, A. K., y Beck, A. (2016). Staying well during pregnancy and after childbirth: A pilot randomized clinical trial of mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 84(2), 134-145. https://doi.org/10.1037/ccp0000068
Duan, C. C., et al. (2025). Internet-based cognitive behavioral therapy for preventing postpartum depressive symptoms among pregnant individuals with depression: Multicenter RCT in China. Journal of Medical Internet Research, 27, e67386. https://doi.org/10.2196/67386
Evans, K., Morrell, C. J., y Spiby, H. (2018). Non-pharmacological interventions to reduce symptoms of mild to moderate anxiety in pregnant women: Systematic review. Journal of Advanced Nursing, 74(2), 289-309. https://doi.org/10.1111/jan.13422
Felder, J. N., Epel, E. S., Neuhaus, J., Krystal, A. D., y Prather, A. A. (2020). Efficacy of digital CBT for the treatment of insomnia symptoms among pregnant women: A randomized clinical trial. JAMA Psychiatry, 77(5), 484-492. https://doi.org/10.1001/jamapsychiatry.2019.4491
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., y Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 106(5 Pt 1), 1071-1083. https://doi.org/10.1097/01.AOG.0000183597.31630.db
Green, S. M., Donegan, E., McCabe, R. E., Streiner, D. L., Agako, A., y Frey, B. N. (2020). Cognitive behavioral therapy for perinatal anxiety: A randomized controlled trial. Australian & New Zealand Journal of Psychiatry, 54(4), 423-432. https://doi.org/10.1177/0004867419898528
Grote, N. K., et al. (2023). Effect of brief interpersonal therapy on depression during pregnancy: A randomized clinical trial. JAMA Psychiatry, 80(6), 539-547. https://doi.org/10.1001/jamapsychiatry.2023.0702
Howard, L. M., Molyneaux, E., Dennis, C. L., Rochat, T., Stein, A., y Milgrom, J. (2014). Non-psychotic mental disorders in the perinatal period. The Lancet, 384(9956), 1775-1788. https://doi.org/10.1016/S0140-6736(14)61276-9
Jimenez-Barragan, M., et al. (2025). Immersive virtual reality eHealth intervention to reduce anxiety and depression in pregnant women: Randomized controlled trial. JMIR Human Factors, 12, e71708. https://doi.org/10.2196/71708
Loughnan, S. A., et al. (2019). A randomized controlled trial of MUMentum Pregnancy: Internet-delivered CBT for antenatal anxiety and depression. Journal of Affective Disorders, 243, 381-390. https://doi.org/10.1016/j.jad.2018.09.057
Page, M. J., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Puertas-Gonzalez, J. A., Romero-Gonzalez, B., Mariño-Narvaez, C., Cruz-Martinez, M., y Peralta-Ramirez, M. I. (2021). La terapia cognitiva-conductual como amortiguadora de los efectos psicológicos negativos del confinamiento por la COVID-19 en mujeres embarazadas. Revista Española de Salud Pública, 95, e202103014.
Atzmon, O., Crowther, M. E., Quin, N., Cassera, L., Wellecke, C., Pinnington, D. M., y Bei, B. (2025). Cognitive behavioral therapy for perinatal insomnia: Exploring adherence, perceived usefulness of intervention components, and their associations with sleep outcomes. Behavioral Sleep Medicine, 23(5), 606-621. https://doi.org/10.1080/15402002.2025.2501704
Salehi, F., Pourasghar, M., Khalilian, A., y Shahhosseini, Z. (2016). Comparison of group CBT and interactive lectures in reducing anxiety during pregnancy. Medicine, 95(43), e5224. https://doi.org/10.1097/MD.0000000000005224
Siebach, K. F., Perin, J., Malik, A., Atif, N., Zaidi, A., Rahman, A., y Surkan, P. J. (2024a). Anxiety-focused CBT delivered by non-specialists to prevent postnatal depression: A randomized, phase 3 trial [NCT03880032]. Scientific Reports.
Siebach, K. F., Perin, J., Malik, A., Atif, N., Zaidi, A., Rahman, A., y Surkan, P. J. (2024b). Results of a CBT-based intervention for antenatal anxiety on birth outcomes in Pakistan: A randomized control trial. Scientific Reports, 14(1), 13806. https://doi.org/10.1038/s41598-024-64119-z
Sockol, L. E., Epperson, C. N., y Barber, J. P. (2015). A meta-analysis of cognitive behavioral therapy for adult perinatal depression. Psychotherapy and Psychosomatics, 84(1), 1-11. https://doi.org/10.1159/000366487
Spinelli, M. G., y Endicott, J. (2003). Controlled clinical trial of interpersonal psychotherapy versus parenting education program for depressed pregnant women. American Journal of Psychiatry, 160(3), 555-562. https://doi.org/10.1176/appi.ajp.160.3.555
Tomfohr-Madsen, L. M., Clayborne, Z. M., Rouleau, C. R., y Campbell, T. S. (2016). Sleeping for two: An open-pilot study of CBT-I in pregnancy. Behavioral Sleep Medicine, 15(5), 377-393. https://doi.org/10.1080/15402002.2016.1141769
Tufanaru, C., Munn, Z., Aromataris, E., Campbell, J., y Hopp, L. (2020). Chapter 3: Systematic reviews of effectiveness. En JBI Manual for Evidence Synthesis. JBI. https://doi.org/10.46658/JBIMES-20-04
Zarenejad, M., Yazdkhasti, M., Rahimzadeh, M., Mehdizadeh Tourzani, Z., y Esmaelzadeh-Saeieh, S. (2020). The effect of mindfulness-based stress reduction on maternal anxiety and self-efficacy: A randomized controlled trial. Brain and Behavior, 10(3), e01561. https://doi.org/10.1002/brb3.1561
Burns, A., O’Mahen, H., Baxter, H., Bennert, K., Wiles, N., Ramchandani, P., Turner, K., Sharp, D., Thorn, J., Noble, S., y Evans, J. (2013). A pilot randomised controlled trial of cognitive behavioural therapy for antenatal depression. BMC Psychiatry, 13, 33. https://doi.org/10.1186/1471-244X-13-33
Duncan, L. G., Cohn, M. A., Chao, M. T., Cook, J. G., Riccobono, J., y Bardacke, N. (2017). Benefits of preparing for childbirth with mindfulness training: A randomized controlled trial with active comparison. BMC Pregnancy and Childbirth, 17, 140. https://doi.org/10.1186/s12884-017-1319-3
Field, T., Diego, M., y Hernandez-Reif, M. (2010). Prenatal depression effects and interventions: A review. Infant Behavior and Development, 33(4), 409-418. https://doi.org/10.1016/j.infbeh.2010.04.005
Kaaya, S., Siril, H., Smith Fawzi, M. C., Aloyce, Z., Araya, R., Kaale, A., Kasmani, M. N., Komba, A., Minja, A., Mwimba, A., Ngakongwa, F., Somba, M., Sudfeld, C. R., y Larson, E. (2022). A peer-facilitated psychological group intervention for perinatal women living with HIV and depression in Tanzania—Healthy Options: A cluster-randomized controlled trial. PLoS Medicine, 19(12), e1004112. https://doi.org/10.1371/journal.pmed.1004112
Lenze, S. N., Potts, M. A., Rodgers, J., y Luby, J. (2020). Lessons learned from a pilot randomized controlled trial of dyadic interpersonal psychotherapy for perinatal depression in a low-income population. Journal of Affective Disorders, 271, 286-292. https://doi.org/10.1016/j.jad.2020.03.084
Shayan, A., Masoumi, S. Z., Shobeiri, F., y Kazemi, F. (2020). The effect of mindfulness-based counselling on the anxiety levels and childbirth satisfaction among primiparous pregnant women: A randomized controlled trial [IRCT20170305032900N3]. Iranian Journal of Nursing and Midwifery Research, 25(4), 339-344. https://doi.org/10.4103/ijnmr.IJNMR_264_19
Urizar, G. G. Jr., y Muñoz, R. F. (2011). Impact of a prenatal cognitive-behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants. Psychoneuroendocrinology, 36(10), 1480-1494. https://doi.org/10.1016/j.psyneuen.2011.04.002
Verbeek, T., Arjadi, R., Honig, A., Spinhoven, P., y Burger, H. (2017). Group-based multicomponent treatment to reduce depressive symptoms in women with co-morbid psychiatric and psychosocial problems during pregnancy: A randomized controlled trial. Journal of Affective Disorders, 228, 153-160. https://doi.org/10.1016/j.jad.2017.07.018
Woolhouse, H., Mercuri, K., Judd, F., y Brown, S. J. (2014). Antenatal mindfulness intervention to reduce depression, anxiety and stress: A pilot randomised controlled trial of the MindBabyBody program in an Australian tertiary maternity hospital. BMC Pregnancy and Childbirth, 14, 369. https://doi.org/10.1186/s12884-014-0369-z
Publicado
2026-07-11
Cómo citar
Guevara, K., & Berenice Castillo, M. (2026). Efectividad de la Psicoterapia durante el Embarazo: Revisión Sistemática de Resultados Maternos, Obstétricos y Neonatales. Ciencia Latina Revista Científica Multidisciplinar, 10(3), 6127-6147. https://doi.org/10.37811/cl_rcm.v10i3.24665
Número
Sección
Ciencias Sociales y Humanas
Derechos de autor 2026 Karel Guevara, María Berenice Castillo
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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