Preterm infants with severe brain injury demonstrate unstable physiological responses during maternal singing with music therapy: a randomized controlled study

Shulamit Epstein, Sofia Bauer, Orly Levkovitz Stern, Ita Litmanovitz, Cochavit Elefant, Dana Yakobson, Shmuel Arnon

Research output: Contribution to journalArticlepeer-review

Abstract

Preterm infants with severe brain injury are at high risk for poor outcomes and, therefore, may benefit from developmental care modalities such as music therapy (MT). In this prospective, randomized intervention, preterm infants with severe brain injury (grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia) who underwent skin-to-skin contact (SSC) with or without maternal singing during MT were evaluated for physiological responses, including autonomic nervous system stability (low frequency (LF)/high frequency (HF) power), heart rate, respiratory rate, oxygen saturation, and behavioral state. Maternal anxiety state and physiological data were also evaluated. A total of 35 preterm infants with severe brain injuries were included in the study analysis. Higher mean ± standard deviation (SD) LF/HF ratio (1.8 ± 0.7 vs. 1.1 ± 0.25, p = 0.01), higher mean ± SD heart rate (145 ± 15 vs. 132 ± 12 beats per minute, p = 0.04), higher median (interquartile range) infant behavioral state (NIDCAP manual for naturalistic observation and the Brazelton Neonatal Behavioral Assessment) score (3 (2–5) vs. 1 (1–3), p = 0.03), and higher mean ± SD maternal anxiety (state-trait anxiety inventory) score (39.1 ± 10.4 vs. 31.5 ± 7.3, p = 0.04) were documented in SSC combined with maternal singing during MT, as compared to SSC alone. Conclusion: Maternal singing during MT for preterm infants with severe brain injury induces physiological and behavioral instability and increases maternal anxiety during NICU hospitalization. A unique MT intervention should be designed for preterm infants with severe brain injury and their mothers.What is Known:• Preterm infants with severe brain injury are at high risk for poor outcomes.• Music therapy benefits brain development of preterm infants without severe brain injury, however it is unknown whether maternal singing during music therapy for preterm infants with severe brain injury is beneficial.What is New:• Maternal singing during music therapy for preterm infants with severe brain injury induces physiological and behavioral instability and increases maternal anxiety during NICU hospitalization.• A unique music therapy intervention should be designed for preterm infants with severe brain injury and their mothers.

Original languageEnglish
Pages (from-to)1403-1412
Number of pages10
JournalEuropean Journal of Pediatrics
Volume180
Issue number5
DOIs
StatePublished - May 2021

Keywords

  • Intraventricular hemorrhage
  • Maternal singing
  • Music therapy
  • Periventricular leukomalacia
  • Preterm infants
  • Skin-to-skin contact

Fingerprint

Dive into the research topics of 'Preterm infants with severe brain injury demonstrate unstable physiological responses during maternal singing with music therapy: a randomized controlled study'. Together they form a unique fingerprint.

Cite this