Explore a music therapy (MT) intervention to support infant recovery post retinopathy of prematurity (ROP) exam.
Prospective, double-masked, randomized, parallel group study of 100 preterm infants exposed to MT (recorded maternal singing/heartbeat) or standard care (SC). Premature Infant Pain Profile (PIPP) measured at: baseline, during the exam, and 1 and 5 min post exam.
Recovery PIPP scores were less with MT vs. SC, but statistical significance not achieved (Mean ± sd: MT 1 min [5.81 ± 2.93] and 5 min [3.91 ± 1.73] vs. SC 1 min [6.40 ± 2.78] and 5 min [4.76 ± 2.07], p = 0.07). Recovery PIPP sores were significantly higher with SC compared to MT when eye exams were longer (p = 0.049) or when exams were more painful (p = 0.04).
Recorded maternal singing and heartbeat can support recovery post ROP exam. For longer/more painful ROP exams, MT may be more effective than SC promoting recovery post exam.
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Fierson WM, AAP American Academy of Pediatrics Section on Ophthalmology, AAP American Academy of Ophthalmology, AAP American Association for Pediatric Ophthalmology and Strabismus, AAP Association for Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2018;142:e20183810.
Schiavenato M, Antos SA, Bell FA, Freedman BR, Kozak AJ, Kroot TB, et al. Development of a scale for estimating procedural distress in the newborn intensive care unit: the procedural load index. Early Hum Dev. 2013;89:615–9.
Dempsey E, McCreery K. Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity. Cochrane Database Syst Rev. 2011;9:CD007645.
Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2016;7:CD001069.
Disher T, Cameron C, Mitra S, Cathcart K, Campbell-Yeo M. Pain-relieving interventions for retinopathy of prematurity: a meta-analysis. Pediatrics. 2018;142:e20180401.
Pirelli A, Savant Levet P, Garetti E, Ancora G, Merazzi D, Bellieni CV, et al. Literature review informs clinical guidelines for pain management during screening and laser photocoagulation for retinopathy of prematurity. Acta Paediatr. 2019;108:593–9.
Bieleninik Ł, Ghetti C, Gold C. Music therapy for preterm infants and their parents: a meta-analysis. Pediatrics. 2016;138:e20160971.
Standley J. Music therapy research in the NICU: an updated meta-analysis. Neonatal Netw. 2012;31:311–6.
Bruscia KE. Defining music therapy. University Park, IL: Barcelona Publishers; 2014.
Bradt J, Dileo C, Magill L, Teague A. Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev. 2016;8:CD006911.
Tang L, Wang H, Liu Q, Wang F, Wang M, Sun J, et al. Effect of music intervention on pain responses in premature infants undergoing placement procedures of peripherally inserted central venous catheter: a randomized controlled trial. Eur J Integr Med. 2018;19:105–9.
Gold C, Erkkilä J, Bonde LO, Trondalen G, Maratos A, Crawford MJ. Music therapy or music medicine? Psychother Psychosom. 2011;80:304.
Haslbeck FB, Bassler D. Music from the very beginning—a neuroscience-based framework for music as therapy for preterm infants and their parents. Front Behav Neurosci. 2018;12:112.
Trehub SE, Becker J, Morley I. Cross-cultural perspectives on music and musicality. Philos Trans R Soc Lond B Biol Sci. 2015;370:20140096.
Koelsch S. Brain correlates of music-evoked emotions. Nat Rev Neurosci. 2014;15:170–80.
Haslbeck FB, Jakab A, Held U, Bassler D, Bucher HU, Hagmann C. Creative music therapy to promote brain function and brain structure in preterm infants: a randomized controlled pilot study. NeuroImage. 2020;25:102171.
Webb AR, Heller HT, Benson CB, Lahav A. Mother’s voice and heartbeat sounds elicit auditory plasticity in the human brain before full gestation. Proc Natl Acad Sci USA. 2015;112:3152–7.
Butt ML, Kisilevsky BS. Music modulates behaviour of premature infants following heel lance. Can J Nurs Res Arch. 2016;31:17–39.
Whipple J. The effect of music-reinforced nonnutritive sucking on state of preterm, low birthweight infants experiencing heelstick. J Music Ther. 2008;45:227–72.
Williamson S, McGrath JM. What are the effects of the maternal voice on preterm infants in the NICU? Adv Neonatal Care. 2019;19:294–310.
Filippa M, Panza C, Ferrari F, Frassoldati R, Kuhn P, Balduzzi S, et al. Systematic review of maternal voice interventions demonstrates increased stability in preterm infants. Acta Paediatr. 2017;106:1220–9.
Detmer MR, Whelan ML. Music in the NICU: The role of nurses in neuroprotection. Neonatal Netw. 2017;36:213–7.
Stevens B, Johnston C, Petryshen P, Taddio A. Premature Infant Pain Profile: development and initial validation. Clin J Pain. 1996;12:13–22.
Stevens B, Johnston C, Taddio A, Gibbins S, Yamada J. The premature infant pain profile: evaluation 13 years after development. Clin J Pain. 2010;26:813–30.
Beltramini A, Milojevic K, Pateron D. Pain assessment in newborns, infants, and children. Pediatr Ann. 2017;46:e387–95.
Pasero C. Pain assessment in infants and young children: Premature Infant Pain Profile. Am J Nurs. 2002;102:105–6.
Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.
Letourneau N. Attrition among adolescents and infants involved in a parenting intervention. Child: Care Health Dev. 2001;27:183–6.
Verriotis M, Jones L, Whitehead K, Laudiano-Dray M, Panayotidis I, Patel H, Meek J, Fabrizi L, Fitzgerald M. The distribution of pain activity across the human neonatal brain is sex dependent. NeuroImage. 2018;178:69–77.
Schenk K, Stoffel L, Bürgin R, Stevens B, Bassler D, Schulzke S, Nelle M, Cignacco E. The influence of gestational age in the psychometric testing of the Bernese Pain Scale for Neonates. BMC pediatrics. 2019;19:20.
Tabachnick BG, Fidell LS, Ullman JB. Chapter 6: Analysis of Covariance. In: Using multivariate statistics. Boston, MA: Pearson; 2007. p.167–200.
Shukla V, Chapla A, Uperiya J, Nimbalkar A, Phatak A, Nimbalkar S. Sucrose vs. skin to skin care for preterm neonatal pain control—a randomized control trial. J Perinatol. 2018;38:1365–9.
Soffer OD, Cornelissen L, Cummings C, Berde C. Morphine compared to placebo for procedural pain in preterm infants: safety, efficacy and equipoise. J Perinatol. 2019;39:1428–31.
We thank Ann Diaz, RN, BSN, MA, NE-BC and Christine Naylor, BSN, RNC-NIC, CBC for their diligent work completing case report forms and collecting data. We thank the ROP team at Orlando Health Winnie Palmer Hospital and the Eye Physicians of Central Florida for their feedback on the study protocol and coordination with the music therapists. Finally, we thank Jeanine Clapsaddle, MA, LMFT, CCLS for her administrative support of the music therapy team with this project.
This project was supported and partially funded by The University of Central Florida, Theta Epsilon Chapter of Sigma Theta Tau International Honor Society through a $500 grant.
Conflict of interest
The authors declare that they have no conflict of interest.
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Corrigan, M.J., Keeler, J.R., Miller, H.D. et al. Music therapy and retinopathy of prematurity screening: using recorded maternal singing and heartbeat for post exam recovery. J Perinatol 40, 1780–1788 (2020). https://doi.org/10.1038/s41372-020-0719-9
Journal of Perinatology (2020)