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

Authors

  • Ning Yang The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
  • Liping Chen Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
  • Haoke Tang Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
  • Yingchun Zeng Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
  • De Chen Guangzhou Institute of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

DOI:

https://doi.org/10.31907/2309-4400.2020.08.10

Abstract

Introduction: 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. Music therapy is emerging with increasing popularity as an additional treatment for ameliorating stress, anxiety and labor pain. This study aimed to examine the effect of music interventions on maternal perinatal mental health and childbirth outcomes to establish comprehensive evidence for clinical decision-making. Methods: This study is a systematic review and meta-analysis. Results: Twenty-six randomized controlled trials (RCTs) involving 3,969 women included in this review. The overall effects indicated that anxiety levels in women in the music group were significantly lower than in the usual care group (SMD =- 4.17, 95% CI: -5.13 to -3.20). The pooled results also indicate that music interventions could significantly reduce depressive symptoms (SMD =-2.66, 95% CI: -4.98 to -0.34). The music interventions also tended to reduce women's stress, but without significantly statistical differences (Z=1.84, P=0.07). Eight studies reported the effects of music interventions on the physical outcomes of pain and blood pressure and pain. Music interventions could significantly reduce pain intensity (SMD =-1.43, 95% CI: -2.67 to -0.18, blood pressure: systolic BP (SMD =-2.23, 95% CI: -3.76 to -0.70), and diastolic BP (SMD =-1.80, 95% CI: -3.00 to -0.61), and reduced heart rate vital signs (SMD =-3.33, 95% CI: -4.36 to - 2.30). Five studies reported the effects of music interventions on women's satisfaction and quality of life, and found that music interventions significantly improved these outcomes (SMD =2.86, 95% CI: 1.66 to 4.05). In terms of child outcomes, the music interventions positively stimulated fetal movement (SMD =1.62, 95% CI: 0.05 to 3.19) and accelerations (SMD =1.08, 95% CI: 0.74 to 1.42). Conclusions: These results suggest that music interventions may have the potential to reduce obstetrical complications, so that application of music interventions across all three trimesters and during labor may be advisable in routine obstetric practice.

References

K. Corbijn van Willenswaard, F. Lynn, J. McNeill J, et al., Music interventions to reduce stress and anxiety in pregnancy: a systematic review and meta-analysis, BMC Psychiatry 17 (1) (2017) 271. https://doi.org/10.1186/s12888-017-1432-x

C. J. Lin, Y. C. Chang, Y. H. Chang, et al., Music interventions for anxiety in pregnant women: a systematic review and meta-analysis of randomized controlled trials, J Clin Med 8 (11) (2019) 1884. https://doi.org/10.3390/jcm8111884

T. McCaffrey, P. S. Cheung, M. Barry, et al., The role and outcomes of music listening for women in childbirth: An integrative review, Midwifery 83 (2020) 102627. https://doi.org/10.1016/j.midw.2020.102627

Q. Wu, Z Liu, X Pang, et al., Efficacy of fiveelement music interventions in perinatal mental health and labor pain: A meta-analysis, Complement Ther Clin Pract 40 (2020) 101217. https://doi.org/10.1016/j.ctcp.2020.101217

S. Rees, S. Channon, C.S. Waters, The impact of maternal prenatal and postnatal anxiety on children’s emotional problems: a systematic review, Eur Child Adolesc Psychiatry 28 (2) (2019) 257–280. https://doi.org/10.1007/s00787-018-1173-5

S. Grigoriadis, L. Graves, M. Peer, et al., Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: systematic review and meta-analysis, J Clin Psychiatry 79 (5) (2018) 17r12011. https://doi.org/10.4088/jcp.17r12011

A. Jarde, M. Morais, D. Kingston, et al., Neonatal outcomes in women with untreated antenatal depression compared with women without depression: a systematic review and metaanalysis, JAMA Psychiatry 73 (8) (2016) 826–837. https://doi.org/10.1001/jamapsychiatry.2016.09.34

U. Gorkem, C. Togrul, Y. Sahiner, et al., Preoperative anxiety may increase postcesarean delivery pain and analgesic consumption, Minerva Anestesiologica 82 (9) (2016) 974–980.

P. Hepp, C. Hagenbeck, B. Burghardt, et al., Measuring the course of anxiety in women giving birth by caesarean section: a prospective study, BMC Pregnancy Childbirth, 16 (1) (2016) 113. https://doi.org/10.1186/s12884-016-0906-z

H. H. Lin, Y. C. Chang, H. H. Chou et al. Effect of music interventions on anxiety during labor: a systematic review and meta-analysis of randomized controlled trials, Peer J, 7 (2019) e6945. https://doi.org/10.7287/peerj.6945v0.1/reviews /4

C.L. Dennis, K. Falah-Hassani, R. Shiri, Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis, Br J Psychiatry 210 (5) (2017) 315–323. https://doi.org/10.1192/bjp.bp.116.187179

Y.W. Koh, C. Y. Chui, C. S. K. Tang, et al., The prevalence and risk factors of paternal depression from the antenatal to the postpartum period and the relationships between antenatal and postpartum depression among fathers in Hong Kong, Depress Res Treat 2014 (2014) 127632. https://doi.org/10.1155/2014/127632

A. Stein, R. M. Pearson, S. H. Goodman, et al., Effects of perinatal mental disorders on the fetus and child, Lancet, 384 (9956) (2014) 1800–1819. https://doi.org/10.1016/s0140-6736(14)61277-0

A.C. Sujan, M.E. Rickert, A.S. Oberg, et al., Associations of maternal antidepressant use during the first trimester of pregnancy with preterm birth, small for gestational age, autism spectrum disorder, and attentiondeficit/hyperactivity disorder in off spring, JAMA 317 (2017) 553–1562. https://doi.org/10.1001/jama.2017.3413

K.A. Yonkers, K. Gilstad-Hayden, A. Forray, et al., Association of panic disorder, generalized anxiety disorder, and benzodiazepine treatment during pregnancy with risk of adverse birth outcomes, JAMA Psychiatry 74 (2017) 1145–1152. https://doi.org/10.1001/jamapsychiatry.2017.27 33

M. P. Freeman, L. Goez-Mogollon, K. A. McInerney, et al., Obstetrical and neonatal outcomes after benzodiazepine exposure during pregnancy: Results from a prospective registry of women with psychiatric disorders,” Gen Hosp Psychiatry 53 (2018) 73–79. https://doi.org/10.1016/j.genhosppsych.2018.05 .010

N. Bernard, J.-C. Forest, G. M. Tarabulsy, et al., Use of antidepressants and anxiolytics in early pregnancy and the risk of preeclampsia and gestational hypertension: a prospective study, BMC Pregnancy Childbirth 19 (1) (2019) 146. https://doi.org/10.1186/s12884-019-2285-8

V. Wulff, P. Hepp, T. Fehm, et al., Music in Obstetrics: An Intervention Option to Reduce Tension, Pain and Stress, Geburtshilfe Frauenheilkd 77 (9) (2017) 967-975. https://doi.org/10.1055/s-0043-118414

C. H. Chuang, P. C. Chen, C. S. Lee, et al., Music intervention for pain and anxiety management of the primiparous women during labour: A systematic review and meta-analysis.” J Adv Nurs 75 (4) (2019) 723-733. https://doi.org/10.1111/jan.13871

W.J. Yang, Y.-M. Bai, L. Qin, et al., The effectiveness of music therapy for postpartum depression: a systematic review and metaanalysis, Complement Ther Clin Pract 37 (2019) 93–101. https://doi.org/10.1016/j.ctcp.2019.09.002

J. P. T. Higgins, J. Thomas, J. Chandler, et al., (editors). Cochrane Handbook for Systematic Reviews of Interventions. 2nd Edition. Chichester (UK): John Wiley & Sons, 2019. https://doi.org/10.1002/9781119536604

Review Manager (RevMan) [Computer program]. Version 5.4. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2020.

H. Kafali, A. Derbent, E. Keskin, et al., Effect of maternal anxiety and music on fetal movements and fetal heart rate patterns, J Matern Fetal Neonatal Med 24 (2011) 461–464. https://doi.org/10.3109/14767058.2010.501122

J. Kushnir, A. Friedman, M. Ehrenfeld, et al., Coping with preoperative anxiety in cesarean section: physiological, cognitive, and emotional effects of listening to favorite music, Birth 39 (2) (2012) 121–127. https://doi.org/10.1111/j.1523- 536x.2012.00532.x

Y. Li, Y. Dong, Preoperative music intervention for patients undergoing cesarean delivery, Int J Gynecol Obstet 119 (1) (2012) 81–83. https://doi.org/10.1016/j.ijgo.2012.05.017

S. Simavli, I. Gumus, I. Kaygusuz, et al., Effect of music on labor pain relief, anxiety level and postpartum analgesic requirement: a randomized controlled clinical trial, Gynecol Obstet Invest 78 (4) (2014a) 244-250. https://doi.org/10.1159/000365085

S. Simavli, I. Kaygusuz, I. Gumus, et al. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health, J Affect Disord 156 (2014b) 194–199. https://doi.org/10.1016/j.jad.2013.12.027

H. Chang H, C. Yu, S. Chen, et al., The effects of music listening on psychosocial stress and maternal–fetal attachment during pregnancy, Complement Ther Med 17 (2015) 2580–2587. https://doi.org/10.1016/j.ctim.2015.05.002

F. S. Dehcheshmeh, H. Rafiei. Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage, Complement Ther Clin Pract 21 (4) (2015) 229-232. https://doi.org/10.1016/j.ctcp.2015.09.002

Y. Zhang, Music therapy combined with motivational psychotherapy for primipara's labor and delivery the impact of the ending, Lab Med Clin J 12 (15) (2015) 2253-2255. [in Chinese]

S. Cao, J. Sun, Y. Wang, et al., Music therapy improves pregnancy-induced hypertension treatment efficacy, Int J Clin Exp Med 9 (2016) 8833–8838.

Y. H. Liu, C. S. Lee, C.H. Yu, et al. Effects of music listening on stress, anxiety, and sleep quality for sleep-disturbed pregnant women, Women Health, 56 (3) (2016) 296-311. https://doi.org/10.1080/03630242.2015.108811 6

M. O. Oh, K. J. Kim, C. H. Baek, et al., Effect of Music Intervention on Maternal Anxiety and Fetal Heart Rate Pattern During Non-Stress Test, J Korean Acade Nurs 46 (3) (2016) 315- 326. https://doi.org/10.4040/jkan.2016.46.3.315

G. Shivamurthy, G. K. Anusha. Effect of Music Therapy on Serum Cortisol in Primigravida in Active Labour, IOSR J Dental Med Sci 15 (4) (2016) 91-94.

E. Karkal, S. Kharde, H. Dhumale, Effectiveness of music therapy in reducing pain and anxiety among primigravid women during active phase of first stage of labor, Int J Nurs Edu 9 (2) (2017) 57–60. https://doi.org/10.5958/0974- 9357.2017.00036.8

C.Nwebube,V.Glover,L. Stewart,Prenatal listening to songs composed for pregnancy and symptoms of anxiety and depression: A pilot study, BMC Complement Altern Med 17 (2017) 256. https://doi.org/10.1186/s12906-017-1759-3

E. Toker, N. Kömürcü, Effect of turkish classical music on prenatal anxiety and satisfaction: A randomized controlled trial in pregnant women with pre-eclampsia, Complement Ther Med 30 (2017) 1–9. https://doi.org/10.1016/j.ctim.2016.11.005

M. Choubsaz, N. Rezavand, A. Bayat, et al., Comparison between the effect of ear plug and music in reducing anxiety in patients undergoing elective cesarean section under spinal anesthesia, Kuwait Med J 50 (2018) 37–42.

J. García-González, M. I. Ventura Miranda, M. Requena Mullor, et al., Effects of prenatal music stimulation on state/trait anxiety in full-term pregnancy and its influence on childbirth: a randomized controlled trial, J Matern Fetal Neonatal Med 31 (8) (2018) 1058-1065. https://doi.org/10.1080/14767058.2017.130651 1

S. Gokyildiz Surucu, M. Ozturk, B. Avcibay Vurgec, et al. The effect of music on pain and anxiety of women during labour on first time pregnancy: a study from Turkey, Complement Ther Clin Prac 30 (2018) 96-102. https://doi.org/10.1016/j.ctcp.2017.12.015

P. Hepp, C. Hagenbeck, J. Gilles, et al., Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study, BMC Pregnancy Childbirth 18 (1) (2018) 435. https://doi.org/10.1186/s12884-018-2069-6

Q. Wan, F. Y. Wen, Effects of acupressure and music therapy on reducing labor pain, Int J Clin Exp Med 11 (2) (2018) 898–903.

D. M. Drzymalski, M. I. Lumbreras-Marquez, L. C. Tsen, et al., The effect of patient-selected or preselected music on anxiety during cesarean delivery: a randomized controlled trial, J Matern Fetal Neonatal Med (2019) 1-7. Online ahead of print. https://doi.org/10.1080/14767058.2019.159476 6

W. Liu, Q. Chen, G. Yang, et al., Effect of auricularpoint pressure combined with personalized music therapy on perioperative stress response in primipara, Zhongguo Zhen Jiu 39 (8) (2019) 827- 831. [in Chinese]

P. Teckenberg-Jansson, S. Turunen, T. Pölkki, et al., Effects of live music therapy on heart rate variability and self-reported stress and anxiety among hospitalized pregnant women: A randomized controlled trial, Nordic J Music Ther 28(1) 7–26. https://doi.org/10.1080/08098131.2018.154622 3

A. Buglione, G. Saccone M. Mas, et al., Effect of music on labor and delivery in nulliparous singleton pregnancies: a randomized clinical trial, Arch Gynecol Obstet 301 (3) (2020) 693-698. https://doi.org/10.1007/s00404-020-05475-9

I. M. Gönenç, H. A. Dikmen, Effects of Dance and Music on Pain and Fear During Childbirth, JOGN Nurs 49 (2) (2020) 144-153. https://doi.org/10.1016/j.jogn.2019.12.005

O. D. Yüksekol, M. Baser, The effect of music on arterial blood pressure and anxiety levels in pregnant women hospitalized due to mild preeclampsia: A pilot randomized controlled trial, Eur J J Integr Med 35 (2020) 101093. https://doi.org/10.1016/j.eujim.2020.101093

S. Koelsch, L. Jäncke, Music and the heart, Eur Heart J 36 (44) (2015) 3043–3049. https://doi.org/10.1093/eurheartj/ehv430

C. O’Callaghan, M. Sexton, G. Wheeler, Music therapy as a non-pharmacological anxiolytic for paediatric radiotherapy patients, Australas Radiol 51 (2) (2007) 159–162. https://doi.org/10.1111/j.1440- 1673.2007.01688.x

L. Wang, X. Chen, J. Ma, Music emotion and its neural basis, Psychol Progress 4 (2014) 738-747. [in Chinese] https://doi.org/10.12677/ap.2014.46098

D. Fancourt, A. Ockelford, A. Belai, The psychoneuroimmunological effects of music: A systematic review and a new model, Brain Behav Immun 36 (2014) 15–26. https://doi.org/10.1016/j.bbi.2013.10.014

M.V. Thoma, R. La Marca, R. Bronnimann, et al., The effect of music on the human stress response, PLoS ONE, 8 (8) (2013) e70156. https://doi.org/10.1371/journal.pone.0070156

S. Arnon Music therapy for hospitalized pregnant women – The way to go forward, Nordic J Music Ther 28 (1) (2019) 4-6. https://doi.org/10.1080/08098131.2018.155469 5

K. Falah-Hassani, R. Shiri, C. L. Dennis, The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis, Psychol Med 47 (12) (2017) 2041-2053. https://doi.org/10.1017/s0033291717000617

J. Henderson, M. Redshaw, Anxiety in the perinatal period: antenatal and postnatal influences and women’s experience of care, J Reprod Infant Psychol 31 (5) (2013) 465–478. https://doi.org/10.1080/02646838.2013.835037

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2020-09-25

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