400 - A Music-Based Intervention to Reduce Stress in the Hospitalized Preterm Infant

Poster Number: 400
Publication Number: 400.135

Madison D. Forde, Brigham and Women's Hospital, Boston, MA, United States; John Sunwoo, Harvard medical school, Boston, MA, United States; Mohamed El-Dib, Harvard Medical School, Boston, MA, United States; Carmina Erdei, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Terrie E. Inder, Harvard Medical School, Boston, MA, United States

Background: Hospitalized preterm infants experience increased stress in the sensory-atypical environment of the Neonatal Intensive Care Unit (NICU). Such stress perturbs infant physiological stability and behavioral state, contributing to longer-term developmental consequences. Music-based interventions may reduce stress, enrich the NICU auditory environment, and improve infant neurodevelopment. Little is known about which specific music conditions and stimulus characteristics can reduce stress and improve behavioral regulation in NICU infants.

Objective: This study investigated the relationships between three music compositions, physiological, and behavioral responses in hospitalized preterm infants.

Design/Methods: : Three 15-minute pieces of original music were employed, developed in partnership with the Bose Corporation. 21preterm infants, with postmenstrual ages between 30 weeks and 35 weeks, 6 days participated in the study (Table 1). Participants was exposed to 12 interventions in a randomized order (3 exposures for each condition); study staff were blinded to music conditions. Outcomes included continuous recordings of heart rate, respiratory rate, oxygen saturation, infant behavioral state organization, and regional cerebral oxygen saturation (rSO2). A repeated measures ANOVA was used to analyze vital sign evolution after each music exposure compared with silence (Condition 4).

Results: Data collected from 18 participants were included in the analyses presented here. No statistically significant changes were observed in vital sign patterns amongst the music conditions when compared to baseline vital signs patterns (Table 1). Respiratory rates decreased after each music condition (Conditions 1, 2, or 3) when compared with silence, with most notable reduction documented after exposure to Condition 2 (Figure 1); however, this result did not reach significance (p=0.5978). Behavioral state regulation ratings trended in the desired (lower) direction one hour after exposure to all Conditions and remained most stable at the lowest rating after exposure to Condition 2. This condition consists of a low, repetitive, and rhythmically consistent music entrainment stimulus. Further statistical analyses inclusive of modeling and multivariate regressions on the full study sample may inform more conclusive results.Conclusion(s): This study provides insight into correlations between specific music characteristics and preterm infant physiologic and behavioral responses. Results of this study will aid in tailoring music interventions to achieve optimal therapeutic results for preterm infants in the NICU.
Table 1. Variables during the studies among Nf216 sessions (18 infants, 12 exposures per infant); Linear mixed model was used to account for repeated exposures of each music in each baby.Table 1. Variables during the studies among Nf216 sessions (18 infants, 12 exposures per infant); Linear mixed model was used to account for repeated exposures of each music in each baby.
Figure 1: Least Squares Means Plot of Respiratory Response Rate over BaselineFigure 1: Least Squares Means Plot of Respiratory Response Rate over Baseline