Music Therapy for Preterm Infants and Their Parents: A Meta-analysis

CONTEXT: Given the recent expansion of research in the area of music therapy (MT) for preterm infants, there is a need for an up-to-date meta-analysis of rigorously designed studies that focus exclusively on MT. OBJECTIVE: To systematically review and meta-analyze the effect of MT on preterm infants and their parents during NICU hospitalization and after discharge from the hospital. DATA SOURCES: PubMed/Medline, PsycINFO, Embase, Cochrane Database of Systematic Reviews, CINAHL, ERIC, Web of Science, RILM. STUDY SELECTION: Only parallel or crossover randomized controlled trials of MT versus standard care, comparison therapy, or placebo were included. DATA EXTRACTION: Independent extraction by 2 reviewers, including risk of bias indicators. RESULTS: From 1803 relevant records, 16 met inclusion criteria, of which 14 contained appropriate data for meta-analysis involving 964 infant participants and 266 parent participants. Overall, random-effects meta-analyses suggested significant large effects favoring MT for infant respiratory rate (mean difference, -3.91/min, 95% confidence interval, -7.8 to -0.03) and maternal anxiety (standardized mean difference, -1.82, 95% confidence interval, -2.42 to -1.22). There was not enough evidence to confirm or refute any effects of MT on other physiologic and behavioral outcomes or on short-term infant and service-level outcomes. There was considerable heterogeneity between studies for the majority of outcomes. LIMITATIONS: This review is limited by a lack of studies assessing long-term outcomes. CONCLUSIONS: There is sufficient evidence to confirm a large, favorable effect of MT on infant respiratory rate and maternal anxiety. More rigorous research on short-term and long-term infant and parent outcomes is required.