Motherly app shows stronger depressive symptom reduction in women with fewer children and higher pediatric consultations

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Archives of women's mental health Published May 22, 2026 Medically reviewed May 22, 2026 Study authors: Borja Tatiane, Fonseca Zuccolo Pedro, Seda Leonardo, Matijasevich Alicia, Vanoni Polanczyk Guilherme… PubMed ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider Motherly app for postpartum depression, noting stronger effects in women with fewer children and higher pediatric consultations.

This study was a secondary analysis of a randomized controlled trial involving 264 women. The intervention was the Motherly app, compared to an active control group. The primary outcome was depressive symptoms assessed by the Edinburgh Postnatal Depression Scale. The secondary outcome was functional impairment by the Clinical Global Impression.

The main results indicated that intervention effects were moderated by the number of children and pediatric consultations. Stronger effects were observed among mothers with fewer children and higher consultation frequency. Additionally, effects were moderated by time spent with the child, with greater improvements among mothers with lower caregiving demands. Total and BA achievements were significantly associated with reduction in depressive symptoms. BA and RCPR mediated the effect of the intervention.

Safety and tolerability data were not reported. Serious adverse events, discontinuations, and general tolerability were not reported. No specific adverse event rates were provided. The study limitations were not reported. Funding or conflicts of interest were not reported. The certainty of the findings regarding subgroup effects is moderate due to the observational nature of the moderation analysis within a trial framework.

The practice relevance is that clinicians should consider the Motherly app for postpartum depression, noting that benefits may be more pronounced in women with fewer children and higher pediatric consultation frequency. Functional impairment benefits may be greater in women with lower caregiving demands.

Study Details

Study typeRct

EvidenceLevel 2

PublishedMay 2026

PMID42171809

View Original Abstract ↓

PURPOSE: The purpose of this study was to identify potential moderators, mediators, and efficacious components of a standalone app intervention on postpartum depression symptoms and functional impairment. METHODS: A total of 264 women were randomized to intervention (Motherly app) or to an active control group. We analyzed depressive symptoms assessed by the Edinburgh Postnatal Depression Scale and functional impairment by the Clinical Global Impression at post-treatment as outcomes. Various potential moderators were assessed at baseline. Potential mediation variables were the level of behavioral activation (BA) measured by the Behavioral Activation for Depression Scale - Short Form and the Response-contingent positive reinforcement (RCPR) by the Reward Probability Index, at post-treatment. Intervention component analysis was evaluated using app engagement data. RESULTS: The results indicate that intervention effects on depressive symptoms were moderated by the number of children and pediatric consultations, with stronger effects observed among mothers with fewer children and higher consultation frequency. Functional impairment was moderated by time spent with the child, with greater improvements among mothers with lower caregiving demands. Mediation analyses showed BA and RCPR mediated the effect of our intervention on depressive symptoms and functional impairment. Total and BA achievements were significantly associated with reduction in depressive symptoms. CONCLUSION: Our findings suggest that our app intervention efficacy is influenced by maternal characteristics and childcare responsibilities. BA and RCPR are key mechanisms, and higher engagement with app components produce greater symptom reduction.