Abstract
Background
Our aim was to investigate the effect of music therapy in combination with skin-to-skin care (SSC) on regional cerebral oxygenation (rSO2) measured with near-infrared spectroscopy (NIRS) in premature infants and to study physiological stability during the interventions.
Methods
This was a prospective single-center observational cohort study conducted in a tertiary neonatal intensive care unit. The study consisted of four phases: (1) baseline measurements in an incubator for 30 min; (2) quiet SSC for 30 min (SSC-Pre); (3) SSC with live maternal singing accompanied by live guitar music for 20 min (SSC-Music); (4) final quiet SSC for another 30 min (SSC-Post).
Results
The primary outcome measure of mean rSO2 for the 31 preterm infants analyzed showed a significant increase from baseline during SSC-Music (76.87% vs 77.74%, p = 0.04) and SSC-Post (76.87% vs 78.0%, p = 0.03) phases. There were no significant changes observed in heart rate (HR), peripheral oxygen saturation (SpO2), and cerebral fractional tissue oxygen extraction (cFTOE). The coefficient of variation (CV) of rSO2 and SpO2 decreased during each intervention phase.
Conclusion
Combining music therapy with SSC appears to be safe in preterm neonates. The impact of the small increase in rSO2 and reduced variability of SpO2 and rSO2 warrants further investigation.
Impact
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Music therapy combined with skin-to-skin care (SSC) is safe in clinically stable premature infants and could be encouraged as part of developmental care.
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This is the first report where near-infrared spectroscopy (NIRS) was used to detect the simultaneous effect of music therapy and SSC on cerebral rSO2 in preterm infants.
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Music therapy with SSC caused a modest increase in rSO2 and decreased the coefficient of variation of rSO2 and peripheral oxygen saturation (SpO2), which suggest short-term benefits for preterm infants.
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Acknowledgements
We wish to thank our statistician Laszlo Szakacs, research student Dr. Eszter Sandor, and cognitive psychologist Anett Rago and Zsuzsanna Varga for their valuable contributions. We would also like to thank our medical and nursing NICU team at the 1st Department of Pediatrics for the professional care and support in facilitating this study. A.J. was supported by the Hungarian Academy of Science, Premium Postdoctoral Fellowship (PPD460004). U.M. was supported by the Higher Education Institutional Excellence Program of the Ministry for Innovation and Technology in Hungary, within the framework of the Neurology thematic program of the Semmelweis University. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
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Each author has met the Pediatric Research authorship requirements. Substantial contributions to conception and design: U.M., T.H., G.B., M.S., and A.J. Acquisition of data, or analysis and interpretation of data: U.M., E.T., K.K., E.S., A.J.C., T.H., and A.J. Drafting the article or revising it critically for important intellectual content and final approval of the version to be published: U.M., E.T., K.K., E.S., A.J.C., T.H., M.S., G.B., and A.J.
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The study was approved by the Ethics Committee of the National Medical Research Council (ETT-TUKEB 13030-1/2017/EKU). Written informed parental consent was obtained for all participants.
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Meder, U., Tarjanyi, E., Kovacs, K. et al. Cerebral oxygenation in preterm infants during maternal singing combined with skin-to-skin care. Pediatr Res 90, 809–814 (2021). https://doi.org/10.1038/s41390-020-01235-2
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DOI: https://doi.org/10.1038/s41390-020-01235-2
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