Effect of music interventions on anxiety during labor: a systematic review and meta-analysis of randomized controlled trials

Hsin-Hui Lin, Yu-Chen Chang, Hsiao-Hui Chou, Chih-Po Chang, Ming-Yuan Huang, Shu-Jung Liu, Chin-Han Tsai, Wei-Te Lei, Tzu-Lin Yeh, Hsin-Hui Lin, Yu-Chen Chang, Hsiao-Hui Chou, Chih-Po Chang, Ming-Yuan Huang, Shu-Jung Liu, Chin-Han Tsai, Wei-Te Lei, Tzu-Lin Yeh

Abstract

Background: Anxiety is commonly experienced during the delivery process and has shown to have adverse effects on maternal and infant health outcomes. Music interventions tend to reduce the effects of anxiety in diverse populations, are low cost, are easily accessible, and have high acceptability. The aim of this review and meta-analysis was to assess the effectiveness of music interventions in reducing anxiety levels among women during labor.

Methods: Seven databases from inception to the end of December, 2018, without any language or time restriction including Embase, PubMed, the Cochrane Library, the Cumulative Index to Nursing and Allied Health, PsycINFO, Airiti Library, and PerioPath: Index to Taiwan Periodical Literature were searched using key terms related to pregnancy, anxiety, and music. Randomized controlled trials that assessed the effect of music during labor and measured anxiety levels as an outcome were included. Meta-analyses were conducted to assess anxiety reduction following a music intervention compared to that after placebo treatment.

Results: A total of 14 studies that investigated a total of 1,310 participants were included in this review. The meta-analyses indicated that those in the intervention group had a significant decrease in anxiety scores (standardized mean difference = -2.40, 95% confidence interval (CI) [-3.29 to -1.52], p < 0.001; I 2 = 97.66%), heart rate (HR) (difference in means = -3.04 beats/min, 95% CI [-4.79 to -1.29] beats/min, p = 0.001; I 2 = 0.00%), systolic blood pressure (SBP) (difference in means = -3.71 mmHg, 95% CI [-7.07 to -0.35] mmHg, p = 0.031; I 2 = 58.47%), and diastolic blood pressure (DBP) (difference in means = -3.54 mmHg, 95% CI [-5.27 to -1.81] mmHg, p < 0.001; I 2 = 0.00%) as compared to the women in the control group.

Conclusions: Music interventions may decrease anxiety scores and physiological indexes related to anxiety (HR, SBP, and DBP). Music interventions may be a good non-pharmacological approach for decreasing anxiety levels during labor.

Keywords: Anxiety; Labor; Music; Pregnancy; Stress.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1. Schematic illustration of the literature…
Figure 1. Schematic illustration of the literature search and the study selection criteria.
CINAH, the cumulative index to nursing and allied health; NTLTD, the net worked digital library of theses and dissertations.
Figure 2. Forest plot of pooled anxiety…
Figure 2. Forest plot of pooled anxiety scores after the intervention between the music intervention group and the placebo group (Overall meta-analysis).
Figure 3. Forest plot of pooled anxiety…
Figure 3. Forest plot of pooled anxiety scores after the intervention between the music intervention group and the placebo group (Subgroup analysis by methods of delivery).
Figure 4. Forest plot of pooled anxiety…
Figure 4. Forest plot of pooled anxiety scores after the intervention between the music intervention group and the placebo group (Subgroup analysis by music types).
Figure 5. Forest plot of heart rate…
Figure 5. Forest plot of heart rate after the intervention between the music intervention group and the placebo group.
Figure 6. Forest plot of systolic blood…
Figure 6. Forest plot of systolic blood pressure after the intervention between the music intervention group and the placebo group.
Figure 7. Forest plot of diastolic blood…
Figure 7. Forest plot of diastolic blood pressure after the intervention between the music intervention group and the placebo group.
Figure 8. Regression of anxiety scores on…
Figure 8. Regression of anxiety scores on Age.

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Source: PubMed

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