Effects of Live Music Therapy on Autonomic Stability in Preterm Infants: A Cluster-Randomized Controlled Trial

Abstract

Unbuffered stress levels may negatively influence preterm-infants’ autonomic nervous system (ANS) maturation, thus affecting neurobehavior and psycho-emotional development. Music therapy (MT) is an evidence-based treatment modality in neonatal care. When coupled with skin-to-skin care (SSC), it may reduce stress responses in both preterm infants and their parents and enhance family-centered care. Accordingly, we aimed to compare the effects of combined MT and SSC and SSC alone on ANS stabilization in preterm infants. In a single-center, cluster-randomized trial design, ten two-month time-clusters were randomized to either combined MT and SSC or SSC alone. Families of preterm infants were offered two sessions of the allocated condition in the NICU, and a three-month follow up session at home. The primary outcome variable was stabilization of the ANS, defined by change in the high frequency (HF) power of heart rate variability (HRV) during the second session. Secondary outcomes included other HRV measures, parent–infant attachment, and parental anxiety at each session. Sixty-eight families were included. MT combined with SSC improved infants’ ANS stability, as indicated by a greater increase in HF power during MT compared to SSC alone (mean difference 5.19 m2/Hz, SE = 1.27, p < 0.001) (95% confidence interval 0.87 to 2.05). Most secondary outcomes were not significantly different between the study groups. MT contributes to preterm-infants’ autonomic stability, thus laying an important foundation for neuro-behavioral and psycho-emotional development. Studies evaluating longer-term effects of MT on preterm infants’ development are warranted.

Music Therapy Intervention in an Open Bay Neonatal Intensive Care Unit Room Is Associated with Less Noise and Higher Signal to Noise Ratios: A Case-Control Study

“…The positive reactions of staff and family to MT, reported in a previous study [ 48 ], may have led to increased attention toward minimizing auditory distraction and reducing unnecessary conversations. Additionally, improvements in infants’ stability, as demonstrated in MT studies with similar IMT intervention [ 49 ], may have led to fewer acute events, with a resulting reduction in monitor alarms. Another explanation may be that parents’ increased relaxation due to MT may have led to fewer conversations and prolonged SSC during MT.…”

Music therapy—An affair of the heart?

“…Yakobson et al. ( 2021 ) fanden eine signifikante Erhöhung der HF über den Verlauf der MT hinweg, jedoch keine signifikante Veränderung der HF im Prä-Peri-Post-Vergleich. In 4 Studien wurde eine signifikante Verringerung der Low Frequency Power (LF) beobachtet (Arnon et al.…”

Parents’ Views with Music Therapy in the Pediatric Intensive Care Unit: A Retrospective Cohort Study

“…The use of MT in neonatal ICUs also suggests that MT is feasible and might have a positive impact on premature children. Little has been reported about the effect of MT in the pediatric ICU (PICU) setting and especially how parents respond to MT [ 6 , 7 , 8 , 9 ]. Therefore, the aim of this study was to describe the perception of MT by parents of children who were exposed to MT in PICU.…”