Interventions among Pregnant Women in the Field of Music Therapy: A Systematic Review

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.

Effect of music therapy on anxiety in full-term pregnant women

Objectives

To examine the impact of receptive music therapy on maternal anxiety both during and after the process of childbirth.

Methods

In this experimental study, 217 women were divided into the receptive music therapy and control groups. The first group were exposed to music at intervals of 20 minutes for a duration of 30 minutes during labor. Data were collected using the Pregnant Information Form, the State Anxiety Inventory (STAI), Visual Analogue Scale and Edinburgh postnatal depression scale.

Results

The pregnant women who participated in the music group exhibited reduced scores of STAI, both during the active time (46.42 ± 11.69 vs. 50.21 ± 11.14, 44.37 ± 10.38 vs. 47.56 ± 11.46, P<0.05) and two hours after giving birth(26.32 ± 6.23 vs. 29.55 ± 8.9, 30.38 ± 7.15 vs. 33.08 ± 9.45, P<0.05). At the first stage of labor, pregnant women in the music group experienced dramatically reduced score of pain in active phase (6.39 ± 1.00 vs. 6.91 ± 0.99, P<0.05) and Edinburgh postnatal depression scale at discharged from the hospital (6.68 ± 3.36 vs. 7.66 ± 3.54, P<0.05).

Conclusion

Receptive music therapy is effective in reducing pain during labor and anxiety during prenatal and postnatal periods. The use of receptive music therapy in obstetric care can be an effective tool in preventing anxiety-induced complications.

Application of Music Therapy in Improving Sleep Quality and Psychological Health of Pregnant Women with Hypertension: A Retrospective Study

OBJECTIVE

The aim of the study was to retrospectively study the effect of music therapy on sleep quality and mental health level of pregnant women with hypertension in pregnancy (HIP).

METHODS

A total of 188 pregnant women with gestational hypertension admitted to The Fourth Hospital of Shijiazhuang from January 2022 to January 2023 were selected as the research objects. Based on various management methods documented in the medical record system, the individuals were divided into a control group (n = 88, routine management) and an observation group (n = 100, routine management + music therapy). The State-Trait Anxiety Inventory (STAI), Athens Insomnia Scale (AIS), and pregnancy outcomes were compared between the two groups.

RESULTS

No significant difference in the STAI and AIS scores before treatment was found between the two groups on admission (P > 0.05). The AIS and STAI scores in the observation group were lower than those in the control group 2 days after delivery (P < 0.05). The total incidence of adverse pregnancy outcomes in the observation group (8.00%) was lower than that in the control group (11.37%), but no significant difference between the two groups (P > 0.05).

CONCLUSIONS

The implementation of music therapy for patients with HIP can alleviate their negative emotions to a certain extent and can improve sleep, offering certain clinical promotion value.

The effects of listening to lullabies and self-selected music at home on prenatal stress and anxiety in nulliparous pregnant women: A randomized-controlled study

To compare the effects of nulliparous pregnant women listening to lullabies and self-selected music on reducing the anxiety and antenatal stress. This was a randomized controlled study. Lullaby group (LG) (n = 40) listened to the lullaby chosen by the researcher, mixed music group (MG) (n = 40) listened to self-selected music and control group (CG) (n = 40) received general care. Post-test anxiety and stress levels was lower in two intervention groups versus CG (p < 0.01). Post-test anxiety was lower in the MG versus LG (p < 0.01), however post-test stress levels were similar. Pregnant women listening to self-selected music at home is more effective in reducing anxiety.

The effect of music-based interventions on short-term postpartum episiotomy pain: A systematic review and meta-analysis

Episiotomy took over as the most common surgery in the field of midwifery that was performed in the second stage of labor to facilitate delivery, and reduce perineal damage. Music is one of the methods used to combat pain. We applied a meta-analysis to investigate whether music-based interventions can reduce short-term postpartum episiotomy pain. Four main English databases including Embase, PubMed, Web of Science, and Scopus were searched until July 2022. All randomized controlled trials (RCTs) with at least two groups (control and intervention) that aimed to measure the effect of music therapy on episiotomy pain were included in the present review. The Cochrane risk of bias checklist was used to assess study quality. Study heterogeneity was determined using the I² statistic and publication bias using Begg's and Egger's tests. Results of random effect analysis are presented as Standard Mean Difference (SMD) with 95% confidence intervals (CI). Data were analyzed using the STATA software version 16. In total, seven articles with 677 subjects were included in the meta-analysis. Overall, the pool estimates of the meta-analysis demonstrated that music therapy has a positive impact on reducing short-term pain derived from episiotomy in both primiparous and multiparous compared to the control group (pooled SMD = -1.60; CI = -2.18, -1.02, p-value<0.001). The heterogeneity was high among including studies (I² = 95.7%, p < 0.001). Our result showed that music-based interventions can be considered a choice for the management of short-term postpartum episiotomy pain among both primiparous and multiparous women. Future studies with large sample sizes and longer follow-up periods will be required to draw better conclusions about the long-term effects on postpartum pain.

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.