Table 3.

(Revised structure – separate maternal and fetal/neonatal safety columns)

Author (Year)	Country	Design	Sample Size (N)	Intervention Details (Protocol)	Control Group	Primary Outcome(s)	Maternal Adverse Events	Fetal/Neonatal Outcomes	Key Efficacy Findings
Kim et al. (2019) [47]	USA	RCT	26 (Active:14, Sham:12)	Site: Right DLPFC; 1 Hz, 100% MT, 900 pulses/session, 20 sessions	Sham rTMS	Depression: HDRS-17, BDI, EPDS, CGI-S	Mild headache (n = 4); scalp discomfort (n = 2)	No congenital anomalies; no adverse neonatal outcomes reported	Significant time×group interaction (p = 0.003); response 81.8% vs. 45.5%
Hızlı Sayar et al. (2014) [48]	Turkey	Open-Label Trial	30	Site: Left DLPFC; 25 Hz, 100% MT, 1000 pulses/session, 18 sessions	N/A	Depression: HAMD-17	Mild headache (n = 6); neck pain (n = 2)	No fetal/neonatal data reported	Mean HAMD decreased 26.77 → 13.03 (p < 0.001)
Kim et al. (2011)  [49]	USA	Open-Label Pilot	10	Site: Right DLPFC; 1 Hz, 100% MT, 20 sessions	N/A	Depression: HDRS	Mild headache (40%); transient uterine contractions (n = 1; resolved)	No adverse pregnancy outcomes	70% response; 30% remission
Klirova et al. (2008)  [50]	Czech Republic	Case Series	2	Pt1: L-DLPFC, 20 Hz, 15 sessions; Pt2: R-DLPFC, 1 Hz, 15 sessions	N/A	Depression: BDI	None reported	One preterm birth (36 weeks); causality unclear	One full remission; one 59% BDI reduction
Zhang et al. (2010)  [51]	Not Reported	Case Report†	1	Sequential unilateral & bilateral; 1 Hz, 90% MT, multiple courses	N/A	Depression: HDRS	None reported	No adverse outcomes reported	HDRS 35 → 12
Nahas et al. (1999)  [52]	Not Specified	Case Report†	1	Site: Left DLPFC; 15 Hz, 110% MT, 25 sessions	N/A	Depression: Not specified	None reported	No fetal/neonatal data reported	No symptom improvement

† Footnote: Study excluded from efficacy synthesis (n < 5 or uncontrolled design); included for safety data extraction only in accordance with eligibility criteria (Sect.  2.2)