Poniente Hospital, Almería, Spain.
Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería, Spain.
J Midwifery Womens Health. 2023 Jan;68(1):35-43. doi: 10.1111/jmwh.13413. Epub 2022 Nov 16.
Anxiety negatively affects pregnant women and their fetuses. It can cause misleading test readings in electronic fetal monitoring, affect the duration of the first stage of labor, and influence certain aspects related to childbirth. This study aimed to evaluate the effects of virtual reality and music therapy on anxiety levels, maternal and fetal physiologic parameters, and labor and birth outcomes.
A total of 343 full-term pregnant women participated in a randomized controlled trial and were divided into 3 parallel groups: music therapy intervention (n = 104), virtual reality intervention (n = 124), and control (n = 115). The interventions were delivered during a nonstress test in the third trimester and during labor. Data were collected from April 2017 to May 2018. Measures included the Spielberger State-Trait Anxiety Inventory, maternal blood pressure, maternal and fetal heart rates, and labor and birth outcomes. The study was registered in the Australian New Zealand Clinical Trial Registry (ACTRN12621001647820).
Women in the music therapy and virtual reality groups had lower levels of anxiety after a nonstress test (P < .001), and the women were more likely to have a reactive nonstress test (P < .001) compared with the control group. After the nonstress test and intervention were complete, the music therapy and virtual reality groups had significant decreases in systolic blood pressure (P < .001), diastolic blood pressure (P < .001), and maternal heart rate (P = .003) compared with the control group. Furthermore, fetuses in the control group were more likely to experience nonreassuring fetal heart rate tracings compared with the music therapy and virtual reality groups, respectively (P = .004).
Our findings support the use of music and virtual reality during nonstress tests and labor as nonpharmacologic interventions to reduce anxiety, improve maternal and fetal physiologic parameters, and improve labor and birth outcomes. This research should be replicated in diverse perinatal settings.
焦虑会对孕妇及其胎儿产生负面影响。它可能导致电子胎儿监护仪的检测结果出现偏差，影响第一产程的持续时间，并影响与分娩相关的某些方面。本研究旨在评估虚拟现实和音乐疗法对焦虑水平、母婴生理参数以及分娩结局的影响。
共有 343 名足月孕妇参与了一项随机对照试验，分为 3 个平行组：音乐治疗干预组（n=104）、虚拟现实干预组（n=124）和对照组（n=115）。干预措施在妊娠晚期和分娩期间的非应激试验中进行。数据收集于 2017 年 4 月至 2018 年 5 月。评估指标包括斯皮尔伯格状态特质焦虑量表、产妇血压、产妇和胎儿心率以及分娩结局。本研究在澳大利亚和新西兰临床试验注册中心（ACTRN12621001647820）注册。
在非应激试验后，音乐治疗和虚拟现实组的女性焦虑水平降低（P<.001），并且与对照组相比，她们更有可能出现反应性非应激试验（P<.001）。在非应激试验和干预完成后，音乐治疗和虚拟现实组的收缩压（P<.001）、舒张压（P<.001）和产妇心率（P=0.003）均显著降低，与对照组相比。此外，与音乐治疗和虚拟现实组相比，对照组的胎儿更有可能出现非反应性胎心监护图（P=0.004）。
我们的研究结果支持在非应激试验和分娩期间使用音乐和虚拟现实作为非药物干预措施，以降低焦虑水平、改善母婴生理参数，并改善分娩结局。这一研究应该在不同的围产期环境中进行复制。
