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

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; I2 = 97.66%), heart rate (HR) (difference in means = −3.04 beats/min, 95% CI [−4.79 to −1.29] beats/min, p = 0.001; I2 = 0.00%), systolic blood pressure (SBP) (difference in means = −3.71 mmHg, 95% CI [−7.07 to −0.35] mmHg, p = 0.031; I2 = 58.47%), and diastolic blood pressure (DBP) (difference in means = −3.54 mmHg, 95% CI [−5.27 to −1.81] mmHg, p < 0.001; I2 = 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.

Music Interventions for Anxiety in Pregnant Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…In the current review, we conducted a more comprehensive research of seven databases and pooled eight RCTs to provide updated evidence that listening to music during pregnancy may have a beneficial effect. These results conform to the findings of a prior review regarding the use of music to reduce anxiety in pregnant women undergoing cesarean section or labor process [34].…”

“…This considerable variation may lead to more heterogeneous results regarding psychological or physiological outcomes [12,13]. However, a previous meta-analysis revealed a significant difference in pregnant women using self-chosen music during labor [34]. Furthermore, a Cochrane review demonstrated that participant-preferred music had greater anxiety-reducing effect than researcher-selected music in patients with chronic heart disease [11].…”

Effects of Music Interventions on Maternal and Child Outcomes in Obstetric Settings: An Updated Systematic Review and Meta-Analysis

“…This updated review is consistent with previous systematic reviews related to the effects of musical intervention on lowering anxiety and pain intensity in study participants during labor [3.10.19]. Additionally, this metaanalysis found a significant decrease in the vital signs of heart rate, SBP and DBP after musical intervention, which is consistent with Lin et al [10]. Musical intervention reduces the objective parameters of HR and BP, which supports the positive findings of the effects of musical intervention on the subjective parameters of stress and anxiety [49].…”

“…Increased levels of stress and anxiety can lead to negative effects on both maternal and child outcomes [4]: Antenatal anxiety and depression can result in increased maternal preterm birth rates and low birth weight [5][6][7]. High levels of anxiety in women during labour and in women undergoing Caesarean section (CS) may result in higher infection risk, elevated blood pressure and heart rates, increased cortisol levels and slower wound healing [8][9][10]. Moreover, high levels of anxiety can also lead to increased analgesic consumption in women undergoing CS, who may also experience higher levels of post-Caesarean pain [8].…”

“…In addition, music intervention may be a good CAM option to resolve mental health problems, as it requires simple technical expertise, and music is an easily accessible, cost-effective and highly acceptable intervention [1,4]. Recent systematic reviews have shown that music-based interventions may reduce perinatal mental health issues during pregnancy [1,2], labour [10] and postpartum [20]. Nevertheless, few published studies are known to have been conducted on the effects of music interventions on maternal perinatal mental health and labour pain during pregnancy, labour and the postnatal period.…”