Do Hospitalized Premature Infants Benefit from Music Interventions? A Systematic Review of Randomized Controlled Trials

Marianne J E Van Der Heijden,Irwin K M Reiss,Monique Van Dijk,M G Myriam Hunink,Johannes Jeekel,Sadaf Oliai Araghi,Jo Thompson Coon

doi:10.1371/journal.pone.0161848

Marianne J E Van Der Heijden, Irwin K M Reiss + Show 5 more

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https://doi.org/10.1371/journal.pone.0161848

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Abstract

ObjectiveNeonatal intensive care units (NICU) around the world increasingly use music interventions. The most recent systematic review of randomized controlled trials (RCT) dates from 2009. Since then, 15 new RCTs have been published. We provide an updated systematic review on the possible benefits of music interventions on premature infants’ well-being.MethodsWe searched 13 electronic databases and 12 journals from their first available date until August 2016. Included were all RCTs published in English with at least 10 participants per group, including infants born prematurely and admitted to the NICU. Interventions were either recorded music interventions or live music therapy interventions. All control conditions were accepted as long as the effects of the music intervention could be analysed separately. A meta-analysis was not possible due to incompleteness and heterogeneity of the data.ResultsAfter removal of duplicates the searches retrieved 4893 citations, 20 of which fulfilled the inclusion/exclusion criteria. The 20 included studies encompassed 1128 participants receiving recorded or live music interventions in the NICU between 24 and 40 weeks gestational age. Twenty-six different outcomes were reported which we classified into three categories: physiological parameters; growth and feeding; behavioural state, relaxation outcomes and pain. Live music interventions were shown to improve sleep in three out of the four studies and heart rate in two out of the four studies. Recorded music improved heart rate in two out of six studies. Better feeding and sucking outcomes were reported in one study using live music and in two studies using recorded music.ConclusionsAlthough music interventions show promising results in some studies, the variation in quality of the studies, age groups, outcome measures and timing of the interventions across the studies makes it difficult to draw strong conclusions on the effects of music in premature infants.

Highlights

Included were all randomized controlled trials (RCT) published in English with at least 10 participants per group, including infants born prematurely and admitted to the neonatal intensive care unit (NICU)
Twenty-six different outcomes were reported which we classified into three categories: physiological parameters; growth and feeding; behavioural state, relaxation outcomes and pain
Health professionals are increasingly aware that the acoustic environment in the neonatal intensive care unit (NICU) may affect infants’ well-being

Summary

Introduction

Health professionals are increasingly aware that the acoustic environment in the neonatal intensive care unit (NICU) may affect infants’ well-being. Where unpredictable noise adversely affects sleep and physiologic stability [1,2], meaningful auditory stimulation, such as music, might contribute to the neurodevelopment of premature infants. Music is defined as intentional sound described in terms of pleasing harmonies, dynamics, rhythm, tempo and volume [3]. Music interventions for the NICU should be soothing and not use too many different elements in terms of instruments, rhythms, timbres, melodies and harmonies [4]. Several observational studies suggest that music might have a positive effect on physiological parameters, feeding and development of premature infants [5,6,7,8,9,10,11,12,13]

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