Effect of music on labor and delivery in nulliparous singleton pregnancies: a randomized clinical trial

BACKGROUND

Women's experience of pain during labor varies greatly, and pain control is a major concern for obstetricians. Several methods have been studied for pain management for women in labor, including drug and non-drug interventions.

OBJECTIVE

To test the hypothesis that in nulliparous women with singleton pregnancies at term, listening to music would reduce the pain level during labor.

METHODS

Parallel group non-blinded randomized clinical trial conducted at a single center in Italy. Nulliparous women in spontaneous labor with singleton pregnancies and vertex presentation admitted in labor and delivery room between 37 0/7 and 42 0/7 weeks of gestation for active phase of labor were eligible, and were randomized in a 1:1 ratio to receive music during labor or no music during labor. Music in labor was defined listening to music from the randomization until the delivery of the baby. The primary endpoint was the pain level during the active phase of labor, recorded using the visual analogue scale (VAS) for pain, ranging from 0 (no pain) to 10 (unbearable pain). The effect of music use during labor on each outcome was quantified as the mean difference (MD) with 95% confidence interval (CI).

RESULTS

During the study period, 30 women agree to take part in the study, underwent randomization, and were enrolled and followed up. 15 women were randomized in the music group, and 15 in the control group. No patients were lost to follow up for the primary outcome. Pain level during the active phase of labor was scored 8.8 ± 0.9 in the music group, and 9.8 ± 0.3 in the control group (MD - 1.00 point, 95% CI - 1.48 to - 0.52; P < 0.01). Music during labor and delivery was also associated with a decreased pain at 1 h postpartum (MD - 2.40 points, 95% CI - 4.30 to - 0.50), and decreased anxiety level during active phase of labor (MD - 19.90 points, 95% CI - 38.72 to - 1.08), second stage of labor (MD - 49.40 points, 95% CI - 69.44 to - 29.36), and at 1 h postpartum (MD - 27.00 points, 95% CI - 47.37 to - 6.63).

CONCLUSION

In nulliparous women with singleton pregnancies at term, listening to music reduces the pain level, and the anxiety level during labor.

TRIAL REGISTRATION

Clinicaltrials.gov NCT03779386.

Modulation of synaptic plasticity by short-term aerobic exercise in adult mice

Physiological effects of different types, of continuous and interval aerobic training, have been largely described and studied in the adult man. It was previously indicated that interval training plays an important role in maximizing both peripheral muscle and central cardiorespiratory adaptations, permitting significant functional improvement even in healthy sedentary subjects. Since the outcome of different aerobic training trials on cognitive processes had never been evaluated, we compared, on an experimental mouse model, the effects of four training exercise protocols, named respectively C100, I100, C50 and I50 depending on the volume and on the type of training proposed, continuous or interval method. Therefore, to asses quantitative and qualitative functional changes, we analyzed several physical parameters before and after 6 weeks training in all four groups with respect to the control sedentary animals and we studied synaptic plasticity, by extracellular in vitro recordings, in hippocampal mouse slices, a region involved in learning and memory processes. We found that all four protocols of exercise applied in this study exerted positive effects on both physical and training parameters inducing weight augmentation, strength endurance and aerobic endurance increase, and potentiation of motor coordination. However, the improvement observed failed to induce an enhancement in synaptic plasticity in three out of four exercise protocols and only in the slices from mice trained with the interval 50% volume exercise the long term potentiation (LTP) increased with respect to the sedentary group. These findings suggest that motor activity exerts positive effects on cognitive processes provided that certain principles are respected, such as the training load and the elements of which it is composed, in order to plan the right quantitative and qualitative parameters and the appropriate recovery periods.