Cerebral oxygenation in preterm infants during maternal singing combined with skin-to-skin care

Background Our aim was to investigate the effect of music therapy in combination with skin-to-skin care (SSC) on regional cerebral oxygenation (rSO(2)) 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 rSO(2) 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 (SpO(2)), and cerebral fractional tissue oxygen extraction (cFTOE). The coefficient of variation (CV) of rSO(2) and SpO(2) 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 rSO(2) and reduced variability of SpO(2) and rSO(2) warrants further investigation. Impact 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. 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. 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.