Music Interventions for Anxiety in Pregnant Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Prenatal anxiety is extremely common and may result in adverse effects on both the mother and the baby. Music interventions have been used to reduce anxiety in various medical patients and in pregnant women during childbirth. This study aims to assess the clinical efficacy of music interventions in women during pregnancy rather than during labor. Seven databases were searched from inception to September 2019 without language restrictions. We included only randomized controlled trials that compared music intervention and control groups for anxiety reduction in pregnant women. We used the revised Cochrane risk-of-bias tool (RoB 2.0) for quality assessment. Finally, 11 studies with 1482 participants were included. The pooled meta-analysis results showed that music interventions significantly decreased anxiety levels (standardized mean difference (SMD), −0.42; 95% confidence interval (CI), −0.83 to −0.02; I2 = 91%). Moreover, subgroup analysis showed that listening to music at home had significant anxiolytic benefits (SMD, −0.28; 95% CI, −0.47 to −0.08; I2 = 0%). However, meta-regression revealed a nonsignificant trend for increase in the anxiety-reducing effects of music interventions with increasing maternal age. In conclusion, music interventions may be beneficial in reducing anxiety and may be applied in pregnant women.

The effects of a music and singing intervention during pregnancy on maternal well-being and mother–infant bonding: a randomised, controlled study

“…Several reviews highlight that music interventions during pregnancy also have a general anxiety reducing effect [ 50 , 80 , 84 ]. Moreover, studies have shown that music interventions among pregnant women have even specific positive effects in risk groups.…”

Effects of Music Interventions on Maternal and Child Outcomes in Obstetric Settings: An Updated Systematic Review and Meta-Analysis

“…Twenty-six RCTs involving 3,969 women in this updated systematic review suggest that current evidence indicates the benefits of music intervention on both maternal and child outcomes. Stress, anxiety and depression are very common in obstetric patients [1,2,4]. For this reason, numerous studies show that musical interventions are widely used to reduce anxiety, depressive symptoms and stress levels in these patients.…”

“…The anxiolytic effect of music may be achieved by activating the release of endorphins, suppressing sympathetic nervous system activity, decreasing cortisol levels, and triggering activity in specific brain regions linked to emotion, modulating anxiety levels [51][52][53]. However, this review differs from previous systematic reviews analyzing the effect of musical intervention on women during pregnancy [1,2]. These reviews analyzed anxiety and stress levels in only a few RCTs (fewer than 10), until 2015.…”

“…Pregnancy and childbirth are highly challenging, as it is an event of significant psychological, social and emotional change for women that may predispose them to stress and anxiety [1][2][3][4]. Increased levels of stress and anxiety can lead to negative effects on both maternal and child outcomes [4]: Antenatal anxiety and depression can result in increased maternal preterm birth rates and low birth weight [5][6][7].…”

“…In addition, music intervention may be a good CAM option to resolve mental health problems, as it requires simple technical expertise, and music is an easily accessible, cost-effective and highly acceptable intervention [1,4]. Recent systematic reviews have shown that music-based interventions may reduce perinatal mental health issues during pregnancy [1,2], labour [10] and postpartum [20]. Nevertheless, few published studies are known to have been conducted on the effects of music interventions on maternal perinatal mental health and labour pain during pregnancy, labour and the postnatal period.…”