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

The role and outcomes of music therapy during pregnancy: a systematic review of randomized controlled trials

INTRODUCTION

The abundant functions of music and its effects on human's mental and physical health have been verified since ancient times, but rarely received attention as an alternative obstetric intervention.

OBJECTIVE

This study aims to investigate the benefits of music therapy on prenatal and delivery experiences of pregnant women.

METHOD

A systematic search for articles was conducted in electronic databases including CINAHL, Web of Science, PubMed/Medline, and CNKI. A total of 240 articles were identified, and 17 studies were selected for this review. The extracted data included author, year, location, sample size, intervention phase, type of music, music therapy strategy, measuring instruments, and results. The data were organized chronologically based on the publication year of each study.

RESULT

The articles indicated that music therapy has advantages in reducing pain during childbirth, lowering anxiety and stress levels in mothers, improving sleep quality, and increasing fetal movements, basal fetal heart rate, and accelerations.

CONCLUSION

Based on the findings, it can be concluded that music therapy is an effective approach to enhance the experience of pregnant women during pregnancy and delivery. Therefore, its implementation in obstetrical clinical practice is highly recommended.

Effect of music intervention on perinatal depressive symptoms: A meta-analysis

BACKGROUND

Little is known about the effect of music intervention on perinatal depressive symptoms (PDS), especially the effectiveness of specific aspects of the intervention. This meta-analysis aimed to evaluate the effectiveness of music intervention and explore the role of different intervention features.

METHODS

Six databases were searched from inception to May 21, 2024, to identify randomized controlled trials evaluating the effect of music intervention on PDS. The Cochrane Risk of Bias (RoB) 2.0 tool was used to assess RoB.

RESULTS

The meta-analysis of 10 studies including 988 participants showed that music intervention significantly improved PDS (standardized mean difference (SMD): 0.61, 95% confidence interval (CI): 0.91, -0.32), with statistical heterogeneity among the studies (I2 = 78%). Subgroup analysis showed significant effects on pregnant and postpartum women, and women with or without perinatal complications. Effects were also significant in low- and middle-income countries (SMD: 0.79, 95% CI: 1.16, -0.42), music medicine (SMD: 0.82, 95% CI: 1.17, -0.47), and total intervention length of less than 6 weeks (SMD: 0.85, 95% CI: 1.25, -0.45), but not in high-income countries, music therapy, or total intervention length of 6 weeks or more. Hospital intervention (SMD: 0.86, 95% CI: 1.41, -0.31) showed greater effects compared with home intervention and hospital combined with home intervention. Six studies had a high overall RoB and four had some concerns.

CONCLUSIONS

Music intervention is effective in alleviating PDS. Interventions in low- and middle-income countries, music medicine, total intervention length of less than 6 weeks, and hospital intervention may be advisable.

The effect of music on pain, anxiety and satisfaction during nonstress testing

OBJECTIVE

To determine the effect of instrumental music played during Nonstress Test (NST) on pain, anxiety and satisfaction.

METHODS

This research was planned as randomised controlled. The sample of the study consists of 64 pregnant women. In data collection, a survey form containing socio-demographic characteristics, State-Trait Anxiety Scale, Visual Analog Scale (VAS) and Evgeny Grinko-Valse piece were used as music.

RESULTS

Among the groups where music was applied, satisfaction with the procedure was significantly high (X2: 12.666, p: 0.049). No significant difference was detected between anxiety and pain conditions (p > 0.05). The scale scores of the groups before and after the procedure were evaluated; Before the procedure, significant differences were detected between the groups in terms of trait anxiety and fear of pain. As a result of the evaluation made after the procedure, there are significant differences between state anxiety and fear of pain (p < 0.05). It was determined that music played during the NST procedure reduced state and trait anxiety. Satisfaction levels are also higher among the group that is listened to music.

CONCLUSION

A successful pregnancy is important for the health of mother and baby. Reducing anxiety and stress, especially during the examinations, ensures that the process continues successfully. It is recommended that music played during pregnancy examinations and screening tests be used in clinics and during the procedure to increase satisfaction and reduce anxiety.

Systematic review on music interventions during pregnancy in favor of the well-being of mothers and eventually their offspring

OBJECTIVE

Mental health affects maternal well-being and indirectly affects the development of fetal brain structures and motor and cognitive skills of the offspring up to adulthood. This study aimed to identify specific characteristics of music interventions that improve validated maternal outcomes.

DATA SOURCES

Randomized controlled trials and systematic reviews investigating music interventions during pregnancy were identified from the start of data sources up to December 2023 using MEDLINE, the Cochrane Central Register of Controlled Trials, or Web of Science.

STUDY ELIGIBILITY CRITERIA

Using Covidence, 2 reviewers screened for randomized controlled trials with ≥3 music interventions during pregnancy and applied either the Perceived Stress Scale score, State-Trait Anxiety Inventory score, Edinburgh Postnatal Depression Scale score, or blood pressure as outcomes.

METHODS

The Cochrane risk-of-bias tool 2, the checklist to assess Trustworthiness in RAndomised Clinical Trials, and the reversed Cohen d were applied. This review was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42022299950).

RESULTS

From 251 detected records, 14 randomized controlled trials and 2375 pregnancies were included. Music interventions varied from 3 to 84 active or passive sessions with either patient-selected or preselected music and a duration of 10 to 60 minutes per session. Thereby, 2 of 4 studies observed a significant decrease in the Perceived Stress Scale, 8 of 9 studies observed a significant decrease in the State-Trait Anxiety Inventory, and 3 of 4 studies observed a significant decrease in the Edinburgh Postnatal Depression Scale. Blood pressure was significantly reduced in 3 of 4 randomized controlled trials. The Cochrane risk-of-bias tool 2 was "high" in 5 of 14 studies or "with concerns" in 9 of 14 studies. Stratifying the Cohen d in 14 intervention arms suggested a big effect in 234 of 469 mothers on blood pressure and in 244 of 489 mothers on maternal anxiety and a medium effect in 284 of 529 mothers on maternal anxiety. Small or very small effects on blood pressure, the Edinburgh Postnatal Depression Scale, and the Perceived Stress Scale were observed in 35 of 70, 136 of 277, and 374 of 784 mothers-to-be, respectively.

CONCLUSION

Our study found a general positive effect of music interventions on maternal stress resilience. This was independent of the music but was influenced by the frequency and empathy of the performances. How far music interventions may improve postnatal development and skills of the offspring should be increasingly evaluated with follow-ups to interrupt vicious epigenetic circles during global pandemics, violent conflicts, and natural catastrophes.

Psychosocial needs of inpatient women with gestational diabetes mellitus: a qualitative study

BACKGROUND

Gestational diabetes mellitus (GDM) is one of the most common medical complications associated with pregnancy. Its treatment requires multidisciplinary cooperation, and identifying the psychosocial needs of patients is important in the management of their condition.

OBJECTIVE

This study investigates the psychosocial needs of inpatient mothers with GDM from the joint perspectives of future mothers and healthcare providers.

METHODS

This qualitative study used a content analysis approach. Semi-structured individual interviews focusing on the psychosocial needs of women with GDM were conducted with twelve women suffering from GDM and eight medical staff. Sampling continued until data saturation.

RESULTS

According to the findings of this study, the psychosocial needs of these mothers were classified into the following categories: Support for worries related to the consequences of the disease, Interpersonal support, Infrastructural support, educational support.

CONCLUSION

The psychosocial needs of inpatient mothers with GDM were identified in this study. Attention to these needs can help enhance the mother's satisfaction and treatment adherence, and reduce worries and anxiety during hospitalisation.

ABBREVIATIONS

GDM: Gestational Diabetes Mellitus; hPGH: human placental growth hormone; COREQ: Consolidated criteria for reporting qualitative research; WHO: World Health Organization; HCP: healthcare provider.

Healthcare practitioners' experiences and perspectives of music in perinatal care in Ireland: An exploratory survey

INTRODUCTION

Evidence shows that music can promote the wellbeing of women and infants in the perinatal period. Ireland's National Maternity Strategy (2016-2026) suggests a holistic approach to woman's healthcare needs and music interventions are ideally placed as a non-pharmacological and cost-effective intervention to improve the quality of care offered to women and infants. This cross-sectional survey aimed to explore the healthcare practitioners' personal and professional experiences of using music therapeutically and its impact and barriers in practice. The survey also investigated practitioners' knowledge and attitudes towards the use of music as a therapeutic tool in perinatal care.

METHODS

A novel online survey was developed and distributed through healthcare practitioners' electronic mailing lists, social media, Perinatal Mental Health staff App, and posters at the regional maternity hospital during 26th June and 26th October 2020. Survey items included demographics, personal and professional use of music, and perspectives on music intervention in perinatal care.

RESULTS

Forty-six healthcare practitioners from across 11 professions were recruited and 42 were included in this study. 98 % of perinatal practitioners used music intentionally to support their wellbeing and 75 % referred to using music in their work. While 90 % found music beneficial in their practice, 15 % reported some negative effect. Around two-thirds of the respondents were familiar with the evidence on music and perinatal wellbeing and 95 % thought there was not enough guidance. 40 % considered music therapy an evidence-based practice and 81 % saw a role for music therapy in standard maternity service in Ireland. The qualitative feedback on how music was used personally and professionally, its' reported benefits, negative effects, and barriers are discussed.

DISCUSSION

This study offers insights into how healthcare practitioners viewed and applied music in perinatal practice. The findings indicate high interest and positive experiences in using music as a therapeutic tool in perinatal care which highlights the need for more evidence and guidance.

The transformative power of music: Insights into neuroplasticity, health, and disease

Music is a universal language that can elicit profound emotional and cognitive responses. In this literature review, we explore the intricate relationship between music and the brain, from how it is decoded by the nervous system to its therapeutic potential in various disorders. Music engages a diverse network of brain regions and circuits, including sensory-motor processing, cognitive, memory, and emotional components. Music-induced brain network oscillations occur in specific frequency bands, and listening to one's preferred music can grant easier access to these brain functions. Moreover, music training can bring about structural and functional changes in the brain, and studies have shown its positive effects on social bonding, cognitive abilities, and language processing. We also discuss how music therapy can be used to retrain impaired brain circuits in different disorders. Understanding how music affects the brain can open up new avenues for music-based interventions in healthcare, education, and wellbeing.

Treatments and regulatory mechanisms of acoustic stimuli on mood disorders and neurological diseases

Acoustic stimuli such as music or ambient noise can significantly affect physiological and psychological health in humans. We here summarize positive effects of music therapy in premature infant distress regulation, performance enhancement, sleep quality control, and treatment of mental disorders. Specifically, music therapy exhibits promising effects on treatment of neurological disorders such as Alzheimer's disease (AD) and Parkinson's disease (PD). We also highlight regulatory mechanisms by which auditory intervention affects an organism, encompassing modulation of immune responses, gene expression, neurotransmitter regulation and neural circuitry. As a safe, cost-effective and non-invasive intervention, music therapy offers substantial potential in treating a variety of neurological conditions.

Movement through motherhood: Exploring mood, wellbeing, and prenatal emotional availability (EA) through EA-based dance intervention

Emotional availability (EA) is a construct that describes the observed emotional connection in parent-child relationships. During pregnancy, EA is assessed only using caregiver sensitivity and nonhostility. We used the nonverbal aspects of these qualities to create a new dance/movement intervention ("EA-Based Dance Intervention"). Given the scarcity of pregnancy interventions, we provided training to participants on how to be emotionally engaged with their unborn babies through dance/movement. The EA-Based Dance Intervention alone comprised the first intervention arm (n = 12). A second intervention arm involved the combination of EA-Based Dance Intervention with brief psychoeducation (n = 10). The third arm was a control group, which received only the assessments (n = 7). Measures of self-reported symptoms of depression and anxiety, emotional expressivity, flourishing, and the (newly developed) self-reported prenatal EA were used at pre- and posttest. The measure of observed prenatal EA was used to compare intervention versus control at posttest only. In this pilot study, we found that participants receiving the EA-Based Dance Intervention alone or combined with psychoeducation, self-reported improved anxiety symptoms and self-reported higher prenatal EA. When compared with the control group, those experiencing EA-Based Dance Intervention reported fewer depressive symptoms from pre- to posttest.

Music as a health resource in pregnancy: A cross-sectional survey study of women and partners in Ireland

BACKGROUND

Wellbeing in pregnancy can have long term effects for women, infants, and families. Research has shown that music can promote maternal health, infant development, and parent-infant bonding. This study aimed to explore women's and their partners' experiences of using music during pregnancy while also considering their perspectives on the potential role of music in maternity care.

METHODS

A cross-sectional online survey was conducted from June to October 2020 in Ireland. 265 respondents including 254 women and 11 partners who were pregnant or had given birth in the past 12 months participated. Descriptive statistics and content analysis were used to analyse the results.

RESULTS

Findings indicated that, during pregnancy, 75% of respondents sang to their unborn baby, 47% created playlists for childbirth, 46% intentionally used music to support their wellbeing, over one-third were not aware of supporting evidence on music for perinatal wellbeing, 88% thought there was not enough guidance, and 70% supported the idea of establishing music therapy in maternity care. Qualitative analysis revealed three themes: 'Positive impacts of music', 'Facilitators and barriers to the use of music during pregnancy', and 'Future visions on implementing music in maternity care'.

CONCLUSION

This study is the first to explore the experience and perspectives of women and partners in Ireland on using music during pregnancy. The findings highlight the need for more music-based resources and education on this topic and suggests an openness amongst women and partners towards the implementation of music therapy in maternity care to promote perinatal health and wellbeing.

Effectiveness of health literacy and relaxing music on quality of sleep and risk for antenatal depression

Background

Pregnant women experience increased sleep disturbances during the third trimester of their pregnancy, which may result in the development of psychological issues in the perinatal period. There is a dearth of interventional studies that combine health literacy and the provision of music for the benefit of pregnant women in South Asia.

Aim

To determine the effectiveness of a combination of Comprehensive Health literacy And Relaxing Music (CHARM) interventions on quality of sleep and risk for antenatal depression among women visiting antenatal outpatient departments of a tertiary hospital in South India.

Methods

A four-arm parallel-group randomized controlled trial was adopted; 128 low-risk primigravid women were recruited and randomly assigned to the four groups using block randomization. The interventions included relaxing music interventions, comprehensive health-literacy interventions, combinations of both as CHARM interventions, and standard antenatal care. All the interventions were provided for four weeks. The quality of sleep among pregnant women was assessed using the Pittsburgh Sleep Quality Index Scale at baseline and after four weeks of intervention. Women at risk of developing antenatal depression were screened using the Edinburgh Postnatal Depression Scale-Antenatal Version.

Results

Pregnant women who received CHARM interventions had significant improvement in quality of sleep when compared with other interventions (F(3,124) =15.0, P < .001, effect size η p2= 0.27). Also, 38 (29.6%) of the included pregnant women were at risk of developing antenatal depression, which was reduced to 21 (16.4%) following the intervention.

Conclusion

CHARM intervention could promote quality sleep and reduce the risk of developing antenatal depression, thereby improving perinatal mental health.

The effect of emotional freedom technique and music applied to pregnant women who experienced prenatal loss on psychological growth, well-being, and cortisol level: A randomized controlled trial

INTRODUCTION

Research has shown that application of emotional freedom technique and music ensures psychological growth, increases well-being, and decreases cortisol level.

PURPOSE

In the study, it was aimed to determine the effect of EFT and music applied to pregnant women who had experienced prenatal loss on their psychological growth, well-being, and cortisol level.

METHODS

The study was conducted as a randomized controlled trial in a city hospital in eastern Türkiye with 159 pregnant women, 53 of whom were in the EFT, 53 in the music group, and 53 in the control group. The study data were collected through Subjective Units of Disturbance Scale (SUDS), Subjective Units of Experience (SUE) Scale, Post Traumatic Growth Inventory (PTGI), and WHO-5 Well-Being Index, and saliva samples were taken for cortisol evaluation. EFT was applied to the women two times every other week; the women in the music group listened to music two times every other week. Throughout the week following the first intervention, the women continued the interventions at home.

RESULTS

It was determined that EFT and music significantly decreased the participants' subjective anxiety and salivary cortisol median scores, the lowest anxiety was in the EFT group, and PTGI and WHO-5 Well-Being Index mean scores increased (p < 0.005). Further analyses showed that EFT was more effective in terms of increasing well-being than music (p < 0.001; a > b > c). It was determined that the anxiety levels and salivary cortisol median values of the control group were statistically significantly higher compared to the EFT and music groups (p < 0.001).

CONCLUSION

It was found that EFT and music applied to the women who had experienced prenatal loss decreased anxiety, ensured psychological growth, improved well-being, and decreased salivary cortisol level.

Exploring the Synergy of Music and Medicine in Healthcare: Expert Insights into the Curative and Societal Role of the Relationship between Music and Medicine

Our study aimed to investigate the correlation between medicine, health perception, and music as well as the role of music in the healthcare setting. To gain insights into the dynamics between these two fields, we gathered opinions from attendees and presenters at an international conference on music medicine, musicians' health, and music therapy. A team of six interviewers conducted a total of 26 semi-structured interviews. The interview guide focused on four predetermined themes: (1) "music in medicine", (2) "performing arts medicine", (3) "music for the individual", and (4) "music for society". The responses were analyzed using grounded theory methods as well as thematic and content analysis. To enhance the analytical strength, investigator triangulation was employed. Within the predefined themes, we identified several subthemes. Theme 1 encompassed topics such as "listening and performing music for treating diseases and establishing non-verbal relationships", "the value of music in specific disorders, end-of-life care, and pain management", and "the design of sound spaces". Theme 2 explored aspects including the "denial and taboo surrounding physical and mental health issues among musicians", "the importance of prevention", and an antithesis: "pain and suffering driving creativity". Theme 3 addressed the "mental role of music in ordinary and extraordinary life" as well as "music's ability to enable self-conditioning". Lastly, Theme 4 examined the role of music in "cultural self-identification" and "development and education for children". Throughout the interviews, participants expressed a lack of knowledge and awareness regarding interdisciplinary research and the fields of music and medicine. Our findings affirm the significance of music therapy and performing arts medicine as well as the broader relationship between music and medicine. They highlight the potential benefits of perception and experiential pathways for individuals and, consequently, for human society.

The effect of using maternal voice, white noise, and holding combination interventions on the heel stick sampling

BACKGROUND

Heel stick sampling, a common procedure in newborns, causes acute pain.

AIMS

This study aims to measure the outcome of five various non-pharmacologic pain relief groups; maternal voice, white noise, holding, maternal voice+holding, and white noise+holding.

METHODS

The study is an open label, randomized controlled trial. A total of 178 newborns were included in this study. Newborns were randomly allocated to each group; white noise (n = 31), maternal voice (n = 31), holding (n = 30), white noise+holding (n = 29), maternal voice+holding (n = 28), and control (n = 29) interventions. Newborns' pain responses were evaluated using the Neonatal Infant Pain Scale (NIPS), and the Premature Infant Pain Profile (PIPP). The primary measured outcomes were the newborns' pain levels, while the secondary outcomes were the heart rate and changes in oxygen saturation. The mean values of pain in neonates between groups were evaluated one minute before (Phase1), during (Phase2), and one minute after (Phase3) the procedure.

RESULTS

The research results are given with comparisons in three time periods (Phase1, Phase2 and Phase3). White noise and white noise+holding were found to have the lowest mean NIPS and PIPP score (p < 0.001). The mean heart rate was found to be the lowest in the white noise+holding group (p < 0.001). There was no significant difference between the groups in terms of oxygen saturation score (p = 0.453).

CONCLUSION

The white noise+holding applied to newborns during heel stick sampling were effective in pain reduction. Nurses and midwives can use white noise+holding method.

IMPLICATIONS TO PRACTICE

These results contribute to the pain management of newborns.

Best Practices in Maternal and Child Health from the Perspective of Healthcare Professionals

Objective: To understand healthcare professionals’ perception of best practices in maternal and child health. Materials and methods: This qualitative exploratory-descriptive study was conducted between December 2020 and March 2021. The study corpus consisted of 23 healthcare professionals from southern Brazil. Data were collected using a semi-structured script and coded based on Minayo’s thematic content analysis proposed. Results: Data analysis enabled the delimitation of two thematic categories: “best practices in maternal and child health: from idealization to accomplishment” and “strategies to qualify the maternal and child healthcare network.” Conclusions: Healthcare professionals recognize the relevance of best practices in maternal and child health, although this process must be expanded and consolidated. Continuing education, hospitality, ambiance, improved access, and the professional-user connection stand out among the qualifying strategies.

Art-based interventions for women's mental health in pregnancy and postpartum: A meta-analysis of randomised controlled trials

OBJECTIVE

Pregnant and postpartum women are vulnerable to psychological problems with a high estimated prevalence. To date, there is no meta-analysis that specifically assesses the effectiveness of art-based interventions to improve mental health in pregnant and postpartum women. The objective of this meta-analysis was to assess the efficacy of art-based interventions when delivered to pregnant and postpartum women.

METHODS

Systematic literature searches were conducted from the inception to 6 March 2022 in seven English databases, including PubMed, Embase, Cochrane Central Register, CINAHL, ProQuest, Scopus, and Web of Science. Randomised controlled trials (RCTs) reporting art-based interventions targeting the improvement of women's mental health in pregnancy and postpartum were included. Cochrane risk of bias tool was applied to assess evidence quality.

RESULTS

Twenty-one randomised controlled trials (RCTs) involving 2,815 participants were eligible for data analysis. A pooled analysis demonstrated that art-based interventions significantly reduced anxiety (SMD = -0.75, 95% CI = -1.10 to -0.40) and depression symptoms (MD = -0.79, 95% CI = -1.30 to -0.28). However, art-based interventions did not alleviate stress symptoms as expected in our findings. Subgroup analysis demonstrated that intervention implementation time, intervention duration and music selected by the participants vs. not could have influence on the efficacy of art-based intervention for anxiety.

CONCLUSION

In perinatal mental health, art-based interventions may be effective in alleviating anxiety and depression. In the future, we still need to conduct high-quality RCTs to validate our findings and enrich clinical application of art-based interventions.

Functionality of self-care for pregnancy mobile applications: A review study

Self-care may help prevent pregnancy complications and mortality by informing parents. Mobile health applications (apps) can help individuals to improve the quality of self-care. Although it has been claimed that mobile apps have various benefits, their functionalities in pregnancy self-care are still unclear. A clear understanding of current apps can help researchers, practitioners, and app developers to identify appropriate functionalities for new development and future refinement of current apps. This review endeavored to identify appropriate functions for pregnancy self-care mobile apps and user interface (UI) features. The scope of this review integrates self-care for pregnancy apps published in Google Play and Cafe Bazaar (an Iranian Android marketplace), popular Android app stores, from July to October 2019 by sing the systematic search technique. All 4196 downloaded apps were installed, and it was found that 76 of them met the inclusion criteria. This way, their features were extracted and categorized by the conventional content analysis. Three main themes and 69 subthemes in terms of apps functionalities and their UI features were extracted as follows: 1) Training materials (maternal and paternal) with 27 subthemes; 2) self-care functionalities (consultations, fetus tracking, clinical examination, supportive assistance, and reminders) with 26 subthemes; and UI features with 16 subtheme. The findings underlined the mHealth solutions for pregnancy self-care and the need for development of the apps regarding the extracted functionalities and UI features; however, controlled trials are needed. It is recommended that transparent reporting of mHealth interventions needs to be prioritized to enable effective interpretation of the extracted data.

Effects of mother-sung lullabies on vaccination-induced infant pain and maternal anxiety: A randomized controlled trial

PURPOSE

This study aimed to investigate the effects of mother-sung lullabies during vaccination on vaccine-induced pain in infants and anxiety in mothers.

DESIGN AND METHODS

Our team conducted a randomized controlled trial with two parallel groups between March 4, 2020 and August 28, 2020, at two family health centers in Turkey. This study included 60 healthy-term infants (lullaby group: 30, control group: 30) aged two months, who received the Bacillus Calmette-Guérin (BCG) vaccine, and their mothers. We used the Information Form, the Neonatal Infant Pain Scale, the Intervention Follow-Up Form (including heart rate, oxygen saturation, and crying duration), and the State Anxiety Inventory as data collection tools.

RESULTS

Infants in the lullaby group had significantly decreased pain responses than those in the control group (p < .05). Further, singing a lullaby resulted in significantly reduced maternal anxiety in the lullaby group compared to the control group (p < .05).

CONCLUSIONS

The lullaby singing method was effective for reducing infants' pain response and mothers' anxiety during vaccination.

PRACTICE IMPLICATIONS

The lullaby method can be used to reduce pain during potentially painful procedures performed in infants and reduce anxiety in mothers. The study is registered under the ClinicalTrials.gov identifier NCT04692584.

The Effect of Music Intervention on Fetal Education via Doppler Fetal Monitor

This study focused on the effects of music intervention on fetal education in pregnant women. The fetal heart rate of the fetus at 30–38 weeks of gestational age was monitored by an ultrasound Doppler fetal monitor, and differences in the frequency of fetal movement responses to familiar and unfamiliar music courses were recorded and analyzed. The analysis results showed that the fetuses had less fetal movement to fixed singing activities, with a mean of 0.7 and a standard deviation of 0.79. On the contrary, the fetuses had significant fetal movement responses to irregular singing, with a mean of 1.73 and a standard deviation of 1.37. The results showed that the fetus receives external sounds through hearing, and a pregnant woman singing fixed music to her fetus can stabilize the frequency of fetal movement, promote the health of herself and the fetus, and establish maternal-fetal bonding.

Effect of Singing on Symptoms in Stable COPD: A Systematic Review and Meta-Analysis

Background

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease which feature is progressive airflow obstruction. Singing is a popular and convenient activity that requires people to manage their lung volumes and airflow actively. Despite the well-known benefits of singing to healthy people, the specific effect still remains unclear.

Objective

To investigate the mental and psychological benefits of singing in patients with stable COPD.

Search Methods

We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) on randomized controlled trials (RCTs) including singing exercise as the main intervention in stable COPD. We searched 8 electronic databases, including Web of Science, PubMed, Embase, Cochrane Library, Clinical Trials.gov, and the Physical Therapy Evidence Database (PEDro), CNKI, and Wanfang Database from inception until May 2022. The searching languages was English or Chinese. Data extraction using standardized templates was performed by two independent reviewers. The quality of the studies was assessed using the PEDro scale. Data synthesis was performed with Revman 5.4. The pooled effect sizes are reported by MD and 95% CI.

Results

Five RCTs involving 333 patients with stable COPD were included in this meta-analysis. Singing was regarded as the main intervention in the experimental group. Meta-analysis revealed that singing improves quality of life on Short Form 36 physical component summary (SF-36 PCS) (MD = 12.63, 95% CI: 5.52 to 19.73, P < 0.01) and respiratory muscle in maximal expiratory pressure (PE_max) (MD = 14.30, 95% CI: 0.87 to 27.73, P = 0.04) in patients with COPD. However, it has limited effects on Short Form 36 mental component summary (SF-36 MCS), lung function, exercise capability, and adverse mental state.

Conclusion

Based on results of the meta-analysis, singing could be used to improve quality of life (SF-36 PCS) and respiratory muscles (PE_max) in patients with COPD.

The Effect of Lullaby Intervention on Anxiety and Prenatal Attachment in Women with High-Risk Pregnancy: A Randomized Controlled Study

BACKGROUND

Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy.

MATERIALS AND METHODS

This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory.

RESULTS

Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl -1.18 to 8.64], p = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference -9.40 [95% Cl -13.91 to -4.88], p < 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl -3.18 to 7.51], p = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], p < 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (p < 0.01), but not in the control group (p > 0.05).

CONCLUSION

Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.

SHAPER-PND trial: clinical effectiveness protocol of a community singing intervention for postnatal depression

INTRODUCTION

Postnatal depression (PND) affects approximately 13% of new mothers. Community-based activities are sought after by many mothers, especially mothers that prefer not to access pharmacological or psychological interventions. Singing has shown positive effects in maternal mood and mother-child bonding. The Scaling-Up Health-Arts Programmes: Implementation and Effectiveness Research-Postnatal Depression study will analyse the clinical and implementation effectiveness of 10-week singing sessions for PND in new mothers. This protocol paper will focus on the clinical effectiveness of this trial.

METHODS AND ANALYSIS

A total of 400 mothers with PND (with a score of at least 10 on the Edinburgh Postnatal Depression Scale) and their babies will be recruited for this hybrid type II randomised controlled trial. The intervention group will attend 10 weekly singing sessions held at community venues or online, facilitated by the arts organisation, Breathe Arts Health Research (Breathe). A control group will be encouraged to attend non-singing sessions in the community or online for 10 weeks. A package of assessments will be collected from participants for clinical, mechanistic and implementation outcomes, at different stages of the trial. Clinical assessments will include questionnaires and interviews for demographics, mental health and social measures, together with biological samples for measurement of stress markers; the study visits are at baseline, week 6 (mid-trial) and week 10 (end of trial), with follow ups at weeks 20 and 36. Multiple imputation will be used to deal with possible missing data and multivariable models will be fitted to assess differences between groups in the outcomes of the study.

ETHICS AND DISSEMINATION

Ethical approval has been granted by the London-West London and GTAC Research Ethics Committee, REC reference: 20/PR/0813.

TRIAL REGISTRATION NUMBER

NCT04834622; Pre-results.

Acute relaxation during pregnancy leads to a reduction in maternal electrodermal activity and self-reported stress levels

BACKGROUND

Prenatal maternal stress can have adverse effects on birth outcomes and fetal development. Relaxation techniques have been examined as potential countermeasures. This study investigates different relaxation techniques and their effect on self-reported stress levels and physiological stress levels in pregnant women.

METHODS

In this cross-sectional study, 38 pregnant women in their 30th to 40th gestational week were assigned to one of three, 20-min lasting relaxation groups: listening to music (N = 12), following a guided imagery (N = 12) or resting (N = 12). The intervention, i.e., acute relaxation (music, guided imagery or resting) took place once for each study participant. Study inclusion criteria were age over 18 years, German speaking, singleton and uncomplicated pregnancy during the 30th and 40th week of gestation. The stress levels were determined during the study. Current stress level during the study was assessed by a visual analogue scale. Chronic stress levels were assessed by the Trier Inventory of Chronic Stress and the Pregnancy Distress questionnaire. Multivariate analyses of covariance were performed and dependent measures included stress levels as well as physiological measures, i.e., cardiovascular activity (electrocardiogram) and skin conductance levels.

RESULTS

All three forms of relaxation led to reduced maternal stress which manifested itself in significantly decreased skin conductance, F(3,94) = 18.011, p = .001, η_p² = .365, and subjective stress levels after the interventions with no significant group difference. Post-intervention stress ratings were further affected by gestational age, with less subjective relaxation in women later in gestation, F (1, 34)=4.971, p = .032, η_p² = .128.

CONCLUSION

Independent of relaxation technique, single, 20-min relaxation intervention (music, guided imagery or resting) can significantly reduce maternal stress. Notably, women at an earlier stage in their pregnancy reported higher relaxation after the intervention than women later in gestation. Hence, gestational age may influence perceived stress levels and should be considered when evaluating relaxation or stress management interventions during pregnancy.

TRIAL REGISTRATION

Not applicable.

The influence of maternal singing on well-being, postpartum depression and bonding - a randomised, controlled trial

BACKGROUND

Postpartum depression is fairly common in new mothers and moreover associated with impaired bonding and poor maternal well-being. The aim of the present study was to investigate the impact of a mother-infant singing intervention within the first three months after birth on maternal well-being, depressive symptoms and bonding.

METHODS

120 women who were recruited at the maternity ward at the University Clinic in Düsseldorf took part in this prospective, randomised-controlled study. Beside the baseline measurement 1-3 days after childbirth, depressive symptoms, maternal well-being and mother-infant bonding were evaluated with questionnaires before (two weeks after birth) and after (twelve weeks after birth) the intervention took place. The experimental group (n = 59) participated in several singing intervention sessions while the control group (n = 61) did not. In the intervention group, salivary cortisol as well as attachment and mood were assessed immediately before and after the singing sessions.

RESULTS

The participants of the intervention group showed a significant reduction of cortisol (p = .023) and an improvement of attachment and mood from start to end of the intervention session (all p ≤ .008). However, no prolonged effects were revealed beyond the intervention sessions as the two groups did not differ regarding the alterations of the primary outcomes postpartum depression (interaction effect p = .187) and postpartum bonding (interaction effect p = .188) in the 10-week period from two up to twelve weeks after childbirth (all p > .05). Additional analyses of singing habits at home in both groups, revealed that only in the singing group more frequent singing was associated with less anxiety and more well-being of the mother.

CONCLUSION

Singing towards the infant seems to have positive immediate effects on the well-being of new mothers (on subjective variables as well as physiological measurements). However, the intervention did not lead to more long lasting positive effects although several limitations should be considered.

TRIAL REGISTRATION

DRKS00015178 (registered at the German Clinical Trial Registry), date of registration: 09.11.2018.

The effect of prenatal music therapy on fetal and neonatal status: A systematic review and meta-analysis

OBJECTIVES

This study aims to investigate the effects of prenatal music therapy on fetal and neonatal status.

DESIGN AND SETTING

A systematic review and meta-analysis of randomized controlled trials.

INTERVENTIONS

Ovid MEDLINE, Embase, Web of Science, Cochrane Library, and Chinese Biomedical Literature Database were searched for studies investigating the effects of prenatal music therapy. Two independent investigators carried out the literature selection, data analysis, and evidence quality assessment. Eligible studies were qualitatively described and synthesized using meta-analyses.

MAIN OUTCOME MEASURES

The outcomes included fetal or neonatal status.

RESULTS

After screening the 821 records yielded by the systematic search, we identified nine eligible studies involving 1419 pregnant women. Eight studies were included in the meta-analysis, and three outcomes were synthesized. Compared with no music therapy, prenatal music therapy did not change fetal heart rate (mean difference [95 % CI]: -0.28 [-3.75-3.20] beat/min, P = 0.88, moderate quality), number of fetal movements (mean difference [95 % CI]: 0.50 [-0.79-1.78] time/min, P = 0.45, low quality), or number of accelerations (mean difference [95 % CI]: 0.16 [-0.87-1.19] time/min, P = 0.76, low quality). This result did not change when two studies with a high risk of bias were excluded. Subgroup analysis showed that prenatal music therapy did not change fetal heart rate, number of fetal movements, or number of accelerations in different intervention phases.

CONCLUSIONS

Prenatal music therapy might not change fetal and neonatal status. However, more systematic strategies of prenatal music therapy deserve further exploration.

How music may support perinatal mental health: an overview

There is strong evidence that engaging with music can improve our health and well-being. Music-based interventions, approaches and practices, such as group music-making (singing or playing musical instruments), listening to music and music therapy, have all been shown to reduce symptoms of depression and anxiety. Although the existing literature needs expanding, mounting evidence suggests that music-based interventions, approaches and practices may help support maternal mental health prenatally and postnatally. The purpose of this descriptive overview is to provide a broad view of this area by bringing together examples of research across different practices and research disciplines. Selected evidence is examined, showing how music-based interventions, approaches and practices can reduce labour anxiety and pain, anxiety symptoms in pregnancy, postnatal depression symptoms and support maternal-infant bonding. The examined research includes single studies and reviews that use both qualitative and quantitative methods. Drawing on animal and human models, the effect of music on foetal behaviour and various possible biological, psychological and social mechanisms are discussed. The potential preventive effect of music-based interventions, approaches and practices and their possible use across different cultures are also considered. Overall, we highlight how music, employed in a variety of ways, may support perinatal mental health with the aim of stimulating more interest and research in this area.