Newborn Research Zurich, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth and Nutrition of the Newborn, Department of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Acta Paediatr. 2023 Dec;112(12):2524-2531. doi: 10.1111/apa.16984. Epub 2023 Oct 3.
We tested the feasibility of a future randomised clinical trial (RCT) in which Creative Music Therapy (CMT), a family-integrating individualised approach in neonatal care, could improve neurodevelopment in extremely preterm infants (EPTs).
In this feasibility trial, 12 EPTs received CMT, while the remaining 19 received standard neonatal care. Socio-demographic data and perinatal complications were compared between groups as risk factors. Bayley Scales of Infant and Toddler Development at 2-year follow-up (FU2) and KABC-II-Kaufman Assessment Battery for Children at 5-year follow-up (FU5) were analysed using the Mann-Whitney U-tests.
Twenty-seven (87.1%) and 18 (58.1%) EPTs attended the FU2 and FU5 examination, respectively. The rate of neurodevelopmental risk factors at birth of the two groups was quite similar. While there was no difference in the FU2 outcomes between groups, there were higher values in the CMT group's Fluid-Crystallised Index of the KABC-II.
Our results indicate neither a beneficial nor a detrimental effect of CMT on neurodevelopment at 2 years but a trend of improved cognitive outcomes at 5 years more similar to cognitive scores of term-born infants than of standard treatment EPTs. The findings favour an RCT but must be interpreted cautiously due to the reduced sample size and non-randomised design.
我们检验了未来一项随机临床试验(RCT)的可行性,即在新生儿护理中采用创造性音乐治疗(CMT)这种以家庭为中心的个体化方法,是否能改善极早产儿(EPT)的神经发育。
在这项可行性试验中,12 名 EPT 接受 CMT 治疗,而其余 19 名接受标准新生儿护理。采用 Mann-Whitney U 检验,对两组之间的社会人口统计学数据和围产期并发症(作为风险因素)进行比较。采用贝利婴幼儿发育量表第二版(Bayley Scales of Infant and Toddler Development)在 2 岁随访(FU2)和 K-ABC-II-考夫曼儿童评估量表(KABC-II-Kaufman Assessment Battery for Children)在 5 岁随访(FU5)时进行分析。
27(87.1%)和 18(58.1%)名 EPT 分别参加了 FU2 和 FU5 检查。两组出生时神经发育危险因素的发生率相当相似。虽然两组在 FU2 结果上没有差异,但 CMT 组的 KABC-II 流体-结晶指数值更高。
我们的结果表明,CMT 对 2 岁时的神经发育既没有有益影响,也没有不良影响,但在 5 岁时认知结果有改善的趋势,与足月出生婴儿的认知评分更相似,而不是标准治疗 EPT 的认知评分。研究结果支持 RCT,但由于样本量减少且设计非随机,必须谨慎解释。