Preterm infants with severe brain injury demonstrate unstable physiological responses during maternal singing with music therapy: a randomized controlled study
Preterm infants with severe brain injury demonstrate unstable physiological responses during maternal singing with music therapy: a randomized controlled study
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DOI：
10.1007/s00431-020-03890-3
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发表时间：
2020-11-26
影响因子：
3.6
通讯作者：
Arnon, Shmuel
中科院分区：
文献类型：
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作者：
Epstein, Shulamit;Bauer, Sofia;Arnon, Shmuel
患有严重脑损伤的早产儿预后不良的风险很高，因此，可能会受益于音乐治疗（MT）等发育护理方式。在这项前瞻性随机干预研究中，在MT过程中，对接受皮肤接触（SSC）伴或不伴母亲唱歌的3级或4级脑室内出血或脑室周围白质软化患者的生理反应，包括自主神经系统的稳定性进行评估（低频（LF）/高频（HF）功率）、心率、呼吸率、氧饱和度和行为状态。母亲的焦虑状态和生理数据也进行了评估。共有35名患有严重脑损伤的早产儿被纳入研究分析。平均值+/-标准差（SD）LF/HF比值较高（1.8 +/-0.7 vs. 1.1 +/-0.25，p = 0.01），平均+/-SD心率较高（145 +/-15 vs. 132 +/-12次/分钟，p = 0.04），较高中位数（四分位距）婴儿行为状态（NIDCAP自然观察手册和Brazelton新生儿行为评估）评分（3（2 - 5）vs. 1（1 - 3），p = 0.03），母亲焦虑的平均值+/-SD更高状态-特质焦虑量表评分（39.1 +/-10.4 vs. 31.5 +/-7.3，p = 0.04）记录在SSC结合MT期间的母亲唱歌中，与单独SSC相比。母亲在患有严重脑损伤的早产儿MT期间唱歌会导致生理和行为不稳定，并增加母亲在NICU住院期间的焦虑。一个独特的MT干预应设计为早产儿严重脑损伤和他们的母亲。
Preterm infants with severe brain injury are at high risk for poor outcomes and, therefore, may benefit from developmental care modalities such as music therapy (MT). In this prospective, randomized intervention, preterm infants with severe brain injury (grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia) who underwent skin-to-skin contact (SSC) with or without maternal singing during MT were evaluated for physiological responses, including autonomic nervous system stability (low frequency (LF)/high frequency (HF) power), heart rate, respiratory rate, oxygen saturation, and behavioral state. Maternal anxiety state and physiological data were also evaluated. A total of 35 preterm infants with severe brain injuries were included in the study analysis. Higher mean +/- standard deviation (SD) LF/HF ratio (1.8 +/- 0.7 vs. 1.1 +/- 0.25, p = 0.01), higher mean +/- SD heart rate (145 +/- 15 vs. 132 +/- 12 beats per minute, p = 0.04), higher median (interquartile range) infant behavioral state (NIDCAP manual for naturalistic observation and the Brazelton Neonatal Behavioral Assessment) score (3 (2-5) vs. 1 (1-3), p = 0.03), and higher mean +/- SD maternal anxiety (state-trait anxiety inventory) score (39.1 +/- 10.4 vs. 31.5 +/- 7.3, p = 0.04) were documented in SSC combined with maternal singing during MT, as compared to SSC alone.Conclusion: Maternal singing during MT for preterm infants with severe brain injury induces physiological and behavioral instability and increases maternal anxiety during NICU hospitalization. A unique MT intervention should be designed for preterm infants with severe brain injury and their mothers.