Effectiveness of Smart Mama application on postpartum depression, anxiety, and maternal-infant bonding among women during the postnatal period: a randomized controlled trial

BACKGROUND: Postpartum depression and anxiety are significant public health concerns that have serious well documented negative effects on mothers and their families. However, they often remain under-recognized because of limited in-person interactions, time restrictions, lack of adequate support, and pervasive stigmatization. This study investigated the effectiveness of the Smart Mama application on postpartum depression, anxiety levels, and maternal-infant bonding at 12 weeks postpartum. MATERIALS AND METHODS: This prospective parallel-group randomized controlled trial included 148 participants from March 1, 2023, to March 31, 2024. Those who agreed to participate were randomly assigned to receive the Smart Mama intervention (n = 74) or routine care (n = 74), using permuted stratified block randomization. The primary outcome was assessed using the Edinburgh Postnatal Depression Scale (EPDS). The secondary outcomes were evaluated using the State-Trait Anxiety Inventory (STAI) and Maternal-Infant Bonding Scale (MIBS) at baseline and the 12-week follow-up using validated standardized tools. RESULTS: Compared with the control group, the Smart Mama intervention group showed a significant reduction in postpartum depressive symptoms (P for time × group interaction = 0.04), with a reduction in the EPDS mean score from 9.03 (standard deviation, 2.47) to 5.61 (3.3), whereas the control group showed a change from 9.01 (2.75) to 7.16 (3.1) at 12 weeks post-intervention. Similarly, the Smart Mama intervention led to a significantly greater decrease in both state and trait anxiety levels (both P for time × group interaction < 0.05) compared to the control group. No statistically significant effect on maternal-infant bonding was observed between the intervention and control group (P for time × group interaction = 0.25). CONCLUSION AND IMPLICATIONS: The Smart Mama intervention significantly reduced postpartum depressive symptoms and anxiety. This study provides empirical evidence and novel insights into the effectiveness of mobile device applications. By integrating a holistic approach, Smart Mama represents a promising and innovative solution for enhancing maternal health outcomes, empowering self-care activities, and overcoming barriers to accessibility. TRIAL REGISTRATION: The study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trial Registry (ID: (UMIN000050065) on January 19, 2023 ( https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000056562 ).