Preterm infant physiological responses to music therapy: a systematic review
Abstract
Background Prematurity is still the leading cause of mortality and morbidity in neonates. The premature change of the environment causes stress, which leads to hemodynamic instability. Music therapy may have a positive impact on hemodynamic parameters of preterm infants in the NICU.
Objective To evaluate preterm infants’ physiological responses to music therapy in NICU setting.
Methods A systematic review was performed in 12 electronic databases from March 2000–April 2018. Our review included all English language publications on parallel or crossover RCTs of music therapy versus standard care or placebo in preterm infants. The outcomes were physiological indicators [heart rate (HR), respiratory rate (RR), and oxygen saturation (SaO2)]. Risk of bias was assessed using the Revised Cochrane risk of bias tool for randomized trials (RoB 2.0).
Results The search yielded 20 articles on 1,148 preterm infants of gestational age 28 and 37 weeks, who received recorded music, recorded maternal/male voice or lullaby, or live music interventions in the NICU with intensity of 30–76 dB. Recorded music improved all outcomes in 6, 6, and 4 of 16 studies for HR, RR, and SaO2, respectively. Seven studies used classical music as melodic elements. However, eight studies showed no significant results on all outcomes.
Conclusion Despite the finding that music interventions demonstrate promising results in some studies, the variation in quality of the studies, age groups, outcome measures, as well as type and timing of the interventions across the studies make it difficult to draw overall conclusions about the effects of music in preterm infants.
References
2. Blencowe H, Cousens S, Oestergaard M, Chou D, Moller A, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in thea year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The Lancet. 2012;379:2162-72.
3. Liu L, Johnson H, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. The Lancet. 2012;379:2151-61.
4. Smith G, Gutovich J, Smyser C, Pineda R, Newnham C, Tjoeng T, et al. Neonatal intensive care unit stress is associated with brain development in preterm infants. Ann Neurol. 2011;70:541-9.
5. Sweet S, McGrath P. Physiological measures of pain. In: Finley G, McGrath P, editors. Measurement of pain in infants and children. Progress in pain research and management. Seattle: IASP Press; 1998. p. 59-81.
6. Tan J, Boskovic D, Angeles D. The energy costs of prematurity and the neonatal intensive care unit (NICU) experience. Antioxidants. 2018;7:1-13.
7. Georgieff M, Brunette K, Tran P. Early life nutrition and neural plasticity. Dev Psychopathol. 2015;27:411-23.
8. Keszler M, Sant’Anna G. Mechanical ventilation and bronchopulmonary dysplasia. Clin Perinatol. 2015;42:781-96.
9. Jensen E, DeMauro S, Kornhauser M, Aghai ZH, Greenspan JS, Dysart KC. Effects of multiple ventilation courses and duration of mechanical ventilation on respiratory outcomes in extremely low-birth-weight infants. JAMA Pediatr. 2015;169:1011-7.
10. Azami M, Jaafari Z, Rahmati S, Farahani A, Badfar G. Prevalence and risk factors of retinopathy of prematurity in Iran: a systematic review and meta-analysis. BMC Ophthalmol. 2018;18:83.
11. Alipour Z, Eskandari N, Ahmari Tehran H, Eshagh Hossaini SK, Sangi S. Effects of music on physiological and behavioral responses of premature infants: a randomized controlled trial. Complement Ther Clin Pract. 2013;19:128-32.
12. Taheri L, Jahromi MK, Abbasi M, Hojat M. Effect of recorded male lullaby on physiologic response of neonates in NICU. Appl Nurs Res. 2017;33:127-30.
13. Whipple J. The effect of music-reinforced nonnutritive sucking on state of preterm, low birthweight infants experiencing heelstick. J Music Ther. 2008;45:227-72.
14. Arnon S, Shapsa A, Forman L, Regev R, Bauer S, Litmanovitz I, et al. Live music is beneficial to preterm infants in the Neonatal Intensive Care Unit environment. BIRTH. 2006;33:131-6.
15. Schlez A, Litmanovitz I, Bauer S, Dolfn T, Regev R, Arnon S. Combining kangaroo care and live harp music therapy in the neonatal intensive care unit setting. Isr Med Assoc J. 2011;13:354-8.
16. Arnon S, Diamant C, Bauer S, Regev R, Sirota G, Litmanovitz I. Maternal singing during kangaroo care led to autonomic stability in preterm infants and reduced maternal anxiety. Acta Paediatr. 2014;103:1039-44.
17. Loewy J, Stewart K, Dassler AM, Telsey A, Homel P. The effects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics. 2013;131:902-18.
18. Auto F, Amancio O, Lanza F. The effect of music on weight gain of preterm infants older than 32 weeks: a randomized clinical trial. Rev Paul Pediatr. 2013;31:e293-9.
19. Jabraeili M, Sabet T, MustafaGharebaghi M, Jafarabadi MA, Arshadi M. The effect of recorded mum's lullaby and Brahm's lullaby on oxygen saturation in preterm infants: a randomized double-blind clinical trial. J Caring Sci. 2016;5:86-93.
20. Butt M, Kisilevsky S. Music modulates behaviour of premature infants following heel lance. Can J Nurs Res. 2000;31:17–39.
21. Lai HL, Chen CJ, Peng TC, Chang FM, Hsieh ML, Huang HY, et al. Randomized controlled trial of music during kangaroo care on maternal state anxiety and preterm infants' responses. Int J Nurs Stud. 2006;43:139-46.
22. Farhat A, Amirib R, Karbandic S, Esmailyd H, Mohammadzadeha A. The effect of listening to lullaby music on physiologic response and weight gain of premature infants. J Neonatal Perinatal Med. 2010;3:103–7.
23. Amini E, Rafiei P, Zarei K, Gohari M, Hamidi M. Effect of lullaby and classical music on physiologic stability of hospitalized preterm infants: a randomized trial. J Neonatal Perinatal Med. 2013;6:295-301.
24. Ayd?n D. Effect of Turkish music that premature infants are made to listen during care on stress, oxygen saturation level and length of hospital stay. International Journal of Human Sciences / Uluslaras? ?nsan Bilimleri Dergisi. 2014;11:655-71.
25. Dearn T, Shoemark H. The effect of maternal presence on premature infant response to recorded music. J Obstet Gynecol Neonatal Nurs. 2014;43:341-50.
26. Wirth L, Dorn F, Wege M, Zemlin M, Lemmer B, Gorbey S, et al. Effects of standardized acoustic stimulation in premature infants: a randomized controlled trial. J Perinatol. 2016;36:486-92.
27. Caparros-Gonzalez RA, de la Torre-Luque A, Diaz-Piedra C, Vico FJ, Buela-Casal G. Listening to relaxing music improves physiological responses in premature infants: A randomized controlled trial. Adv Neonatal Care. 2018;18:58-69.
28. Johnston C, Filion F, Nuyt A. Recorded maternal voice for preterm neonates undergoing heel lance. Adv Neonatal Care. 2007;7:258–66.
29. Polin RA, Abman SH, Rowitch D, Benitz WE, Fox WW. Fetal and neonatal physiology. 5th ed. Philadelphia: Elsevier; 2017. p.1406-7.
30. Chang EF, Merzenich MM. Environmental noise retards auditory cortical development. Science. 2003;300:498-502.
31. Warren J. How does the brain process music? Clin Med. 2008;8:32-6.
32. Stefanics G, Háden G, Huotilainen M, Balázs L, Sziller I, Beke A, et al. Auditory temporal grouping in newborn infants. Psychophysiology. 2007;44:697–702.
33. Winkler I, Haden GP, Ladinig O, Sziller I, Honing H. Newborn infants detect the beat in music. Proc Natl Acad Sci. 2009;106:2468-71.
34. Nozaradan S. Exploring how musical rhythm entrains brain activity with electroencephalogram frequency-tagging. Philos Trans R Soc Lond B Biol Sci. 2014;369:20130393.
35. Ehrhart J, Toussaint M, Simon C, Gronfier C, Luthringer R, Brandenberger G. Alpha activity and cardiac correlates: three types of relationships during nocturnal sleep. Clin Neurophysiol. 2000;111:940-6.
36. Bhoria R, Singal P, Verma D. Analysis of effect of sound levels of EEG. IJATER. 2012;2:122-4.
37. Committee on Environmental Health. Noise: A hazard for the fetus and newborn. Pediatrics. 1997;100:724.
38. Yamamoto T, Ohkuwa T, Itoh H, Kitoh M, Teresawa J, Tsuda T, et al. Effects of pre-exercise listening to slow and fast rhythm music on supramaximal cycle performance and selected metabolic variables. . Arch Physiol Biochem. 2003;111:211–4.
39. Balter M. Evolution of behavior. Seeking the key to music. Science. 2004;306:1120–2.
40. Schwilling D, Vogeser M, Kirchhoff F, Schwaiblmair F, Boulesteix AL, Schulze A, et al. Live music reduces stress levels in very low-birthweight infants. Acta Paediatr. 2015;104:360-7.
41. Standley JM. A meta-analysis of the efficacy of music therapy for premature infants. J Pediatr Nurs. 2002;17(2):107-13.
42. Trehub SE, Trainor L. Singing to infants: lullabies and play songs. In: Rovee-Collier C, Lipsitt LP, Hayne H, editors. Advances in infancy research. Norwood, NJ: Ablex Publishing Co; 1998.
43. Verrusio W, Ettorre E, Vicenzini E, Vanacore N, Cacciafesta M, Mecarelli O. The Mozart effect: A quantitative EEG study. Conscious Cogn. 2015;35:150-5.
44. Keidar HR, Mandel D, Mimouni FB, Lubetzky R. Bach music in preterm infants: no ‘Mozart effect’ on resting energy expenditure. J Perinatol. 2014;34:153-5.
45. Doheny L, Hurwitz S, Insoft R, Ringer S, Lahav A. Exposure to biological maternal sounds improves cardiorespiratory regulation in extremely preterm infants. J Matern Fetal Neonatal Med. 2012;259:1591–4.
46. Schmidt LA, Trainor LJ, Santesso DL. Development of frontal electroencephalogram (EEG) and heart rate (ECG) responses to affective musical stimuli during the first 12 months of post-natal life. Brain Cogn. 2003;52:27-32.
Copyright (c) 2018 Ferry Liwang, Dinarda Ulf Nadobudskaya, Indah Lestari, Toto Wisnu Hendrarto
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2018-10-12
Published 2018-10-15
