Yakobson Dana, Gold Christian, Beck Bolette Daniels, Elefant Cochavit, Bauer-Rusek Sofia, Arnon Shmuel
Music Therapy Department, Institute for Communication and Psychology, Aalborg University, 9000 Aalborg, Denmark.
Neonatal Department, Meir Medical Center, Kfar Saba 44281, Israel.
Children (Basel). 2021 Nov 22;8(11):1077. doi: 10.3390/children8111077.
Unbuffered stress levels may negatively influence preterm-infants' autonomic nervous system (ANS) maturation, thus affecting neurobehavior and psycho-emotional development. Music therapy (MT) is an evidence-based treatment modality in neonatal care. When coupled with skin-to-skin care (SSC), it may reduce stress responses in both preterm infants and their parents and enhance family-centered care. Accordingly, we aimed to compare the effects of combined MT and SSC and SSC alone on ANS stabilization in preterm infants. In a single-center, cluster-randomized trial design, ten two-month time-clusters were randomized to either combined MT and SSC or SSC alone. Families of preterm infants were offered two sessions of the allocated condition in the NICU, and a three-month follow up session at home. The primary outcome variable was stabilization of the ANS, defined by change in the high frequency (HF) power of heart rate variability (HRV) during the second session. Secondary outcomes included other HRV measures, parent-infant attachment, and parental anxiety at each session. Sixty-eight families were included. MT combined with SSC improved infants' ANS stability, as indicated by a greater increase in HF power during MT compared to SSC alone (mean difference 5.19 m/Hz, SE = 1.27, < 0.001) (95% confidence interval 0.87 to 2.05). Most secondary outcomes were not significantly different between the study groups. MT contributes to preterm-infants' autonomic stability, thus laying an important foundation for neuro-behavioral and psycho-emotional development. Studies evaluating longer-term effects of MT on preterm infants' development are warranted.
无缓冲的应激水平可能会对早产儿自主神经系统（ANS）的成熟产生负面影响，从而影响神经行为和心理情感发育。音乐疗法（MT）是新生儿护理中一种有循证依据的治疗方式。当与肌肤相亲护理（SSC）相结合时，它可能会降低早产儿及其父母的应激反应，并加强以家庭为中心的护理。因此，我们旨在比较MT与SSC联合应用和单独使用SSC对早产儿ANS稳定的影响。在一项单中心、整群随机试验设计中，将10个为期两个月的时间群组随机分为MT与SSC联合组或单独的SSC组。为早产儿家庭在新生儿重症监护病房（NICU）提供两次分配条件下的治疗，并在家庭中进行为期三个月的随访。主要结局变量是ANS的稳定，定义为第二阶段心率变异性（HRV）高频（HF）功率的变化。次要结局包括每次治疗时的其他HRV指标、母婴依恋和父母焦虑。共纳入68个家庭。与单独的SSC相比，MT与SSC联合应用可改善婴儿的ANS稳定性，MT期间HF功率的增加更大（平均差异5.19 m/Hz，SE = 1.27，P < 0.001）（95%置信区间0.87至2.05）。研究组之间的大多数次要结局没有显著差异。MT有助于早产儿的自主稳定，从而为神经行为和心理情感发育奠定重要基础。有必要开展评估MT对早产儿发育长期影响的研究。
