Musical and vocal interventions to improve neurodevelopmental outcmes for preterm infants: a cochrane intervention review

Systematic reviews of mixed methodological quality have demonstrated ambiguous results for the efficacy of auditory stimulation in preterm infants. A more comprehensive and rigorous systematic review is needed to address controversies arising from conflicting studies and reviews. We aimed to assess the overall efficacy of auditory stimulation for physiological and neurodevelopmental outcomes in preterm infants compared to standard care according to the standards of the Cochrane Collaboration.

Our review includes randomized controlled trials with preterm infants and their parents evaluating any musical or vocal stimulation provided live or recorded. Primary outcomes were a) infant oxygen saturation, b) Bayley Scales of Infant and Toddler Development (BSID) scores at two years, and c) parental anxiety. Further physiological, social-emotional, and neurodevelopmental outcomes in preterm infants and parental well-being were assessed. A comprehensive data search was done until November 2021, and data collection and analysis were performed according to the guidelines of Cochrane Neonatal.

Of 7577 screened studies, 25 trials were included recruiting 1532 infants and 691 parents. Music/ vocal interventions do not increase oxygen saturation during the intervention (mean difference (MD) 0.13, 95% CI -0.33 to 0.59; P = 0.59; 958 infants, 10 studies; high-certainty evidence) and probably do not increase oxygen saturation postintervention (MD 0.63, 95% CI -0.01 to 1.26; P = 0.05; 800 infants, 7 studies; moderate-certainty evidence). The intervention may result in no difference in infant development (assessed using the BSID), e.g., with the cognitive composition score (MD 0.35, 95% CI -4.85 to 5.55; P= 0.90; 69 infants, 2 studies; low-certainty evidence). The evidence suggests that music/ vocal interventions do not reduce parental state-trait anxiety (MD -1.12, 95% CI -3.20 to 0.96; P= 0.29; 97 parents, 4 studies; low-certainty evidence).

Music/ vocal interventions probably reduce heart rates during the intervention (MD -1.38, 95% CI -2.63 to -0.12; P = 0.03; 1014 infants; 11 studies; moderate-certainty evidence). The beneficial effect was even stronger postintervention. Music/ vocal reduce heart rate postintervention (MD -3.80, 95% CI -5.05 to -2.55; P = P < 0.00001; 903 infants, 9 studies; high-certainty evidence).

Music/ vocal interventions, compared to standard care, result in no difference in oxygen saturation or respiratory rate and may not result in no differences in infant development and parental anxiety. However, music/ vocal interventions probably reduce heart rates in preterm infants during the intervention, and this beneficial effect is even stronger postintervention. Due to low-certainty evidence for all other outcomes, we could not draw any further conclusions regarding overall efficacy nor the possible impact of different intervention types, frequencies, or durations of outcomes.

Publikationsverlauf

Artikel online veröffentlicht:
06. Juni 2023