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  • Systematic Review
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Effectiveness of music therapy intervention on parent-infant attachment and parental anxiety in premature infants care: a systematic review and meta-analysis

Pediatric Research (2026)Cite this article

Abstract

Background

Premature birth can pose challenges to parent-infant attachment and increase parental anxiety. Music therapy has been proposed as an intervention, but its effectiveness remains unclear.

Methods

Six databases (Cochrane Library, Web of Science, EBSCO, Embase, PubMed, and Scopus) were searched until January 15, 2025. Eligible studies were randomized controlled trials that evaluated the effects of music intervention versus routine care on parental anxiety and parent-infant attachment in caring for premature infants. Quality assessment was conducted using the Cochrane Risk of Bias 2 tool. Random-effects meta-analyses were performed with heterogeneity assessed via I2 statistics and Q tests. The Grading of Recommendations, Assessment, Development and Evaluation approach evaluated overall evidence quality.

Results

After comprehensive screening, 13 randomized controlled trials published between 2014 and 2024 were included, encompassing 1034 participants with preterm infants. The meta-analysis revealed no statistically significant improvement in parent-infant attachment or parental anxiety with music therapy compared to conventional care. However, subgroup analysis indicated that frequent music therapy interventions (≥once daily) positively influenced parent-infant attachment (SMD = −1.08, 95% CI: [−1.92, −0.24], p = 0.01).

Conclusions

Overall, music therapy may not reduce parental anxiety or improve attachment, but frequent interventions demonstrated promising potential and warrant further investigation.

Registration number

PROSPERO CRD42025643424.

Impact statement

  • This review indicates that music therapy, compared to standard care, shows no significant effects on parent-infant attachment or parental anxiety in the care of premature infants.

  • However, more frequent (≥once daily) music therapy shows more promising results in improving parent-infant attachment, suggesting the importance of intervention intensity.

  • These insights inform the development of targeted daily therapy protocol to enhance preterm care outcomes.

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Fig. 1: PRISMA flow diagram of literature screening.
Fig. 2: Quality assessment of included studies on parent-infant attachment.
Fig. 3: Quality assessment of included studies on parental anxiety.
Fig. 4: GRADE assessment of evidence quality.
Fig. 5: Meta-analysis of music therapy on parent-infant attachment.
Fig. 6: Meta-analysis of music therapy on parental anxiety.
Fig. 7: Meta-analysis of music therapy on parental anxiety of fathers.

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Data availability

All the sources of data are publicly available and referenced in the document.

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Acknowledgements

The authors extend their sincere thanks to our colleagues for their valuable insights and professional support during the preparation of this manuscript.

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Authors and Affiliations

  1. Communication University of China, Nanjing, Jiangsu, China

    Fan Sun

  2. The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

    Di Tang

  3. Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China

    Di Tang

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  1. Fan Sun
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  2. Di Tang
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S.F. conceptualized the study, designed the methodology, performed the analysis, and drafted the manuscript. D.T. reviewed and revised the manuscript and supervised the study.

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Correspondence to Di Tang.

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Sun, F., Tang, D. Effectiveness of music therapy intervention on parent-infant attachment and parental anxiety in premature infants care: a systematic review and meta-analysis. Pediatr Res (2026). https://doi.org/10.1038/s41390-025-04739-x

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