TY - JOUR
T1 - Effect of Music Therapy on Parent-Infant Bonding Among Infants Born Preterm
T2 - A Randomized Clinical Trial
AU - Ghetti, Claire M.
AU - Gaden, Tora Söderström
AU - Bieleninik, Łucja
AU - Kvestad, Ingrid
AU - Assmus, Jörg
AU - Stordal, Andreas Størksen
AU - Sanchez, Luisa Fernanda Aristizabal
AU - Arnon, Shmuel
AU - Dulsrud, Jeanette
AU - Elefant, Cochavit
AU - Epstein, Shulamit
AU - Ettenberger, Mark
AU - Glosli, Heidi
AU - Konieczna-Nowak, Ludwika
AU - Lichtensztejn, Marcela
AU - Lindvall, Merethe Wolf
AU - Mangersnes, Julie
AU - Fernández, Luz Dary Murcia
AU - Røed, Catharina Janner
AU - Saá, Gladys
AU - Van Roy, Betty
AU - Vederhus, Bente Johanne
AU - Gold, Christian
N1 - Publisher Copyright:
© 2023 American Medical Association. All rights reserved.
PY - 2023/5/26
Y1 - 2023/5/26
N2 - IMPORTANCE: Parent-infant bonding contributes to long-term infant health but may be disrupted by preterm birth.OBJECTIVE: To determine if parent-led, infant-directed singing, supported by a music therapist and initiated in the neonatal intensive care unit (NICU), improves parent-infant bonding at 6 and 12 months.DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted in level III and IV NICUs in 5 countries between 2018 and 2022. Eligible participants were preterm infants (under 35 weeks' gestation) and their parents. Follow-up was conducted across 12 months (as part of the LongSTEP study) at home or in clinics. Final follow-up was conducted at 12 months' infant-corrected age. Data were analyzed from August 2022 to November 2022.INTERVENTION: Participants randomized to music therapy (MT) plus standard care or standard care alone during NICU admission, or to MT plus standard care or standard care alone postdischarge, using computer-generated randomization (ratio 1:1, block sizes of 2 or 4 varying randomly), stratified by site (51 allocated to MT NICU, 53 to MT postdischarge, 52 to both, and 50 to neither). MT consisted of parent-led, infant-directed singing tailored to infant responses and supported by a music therapist 3 times per week throughout hospitalization or 7 sessions across 6 months' postdischarge.MAIN OUTCOME AND MEASURE: Primary outcome was mother-infant bonding at 6 months' corrected age, measured by the Postpartum Bonding Questionnaire (PBQ), with follow-up at 12 months' corrected age, and analyzed intention-to-treat as group differences.RESULTS: Of 206 enrolled infants with 206 mothers (mean [SD] age, 33 [6] years) and 194 fathers (mean [SD] age, 36 [6] years) randomized at discharge, 196 (95.1%) completed assessments at 6 months and were analyzed. Estimated group effects for PBQ at 6 months' corrected age were 0.55 (95% CI, -2.20 to 3.30; P = .70) for MT in the NICU, 1.02 (95% CI, -1.72 to 3.76; P = .47) for MT postdischarge, and -0.20 (95% CI, -4.03 to 3.63; P = .92) for the interaction (12 months: MT in NICU, 0.17; 95% CI, -2.71 to 3.05; P = .91; MT postdischarge, 1.78; 95% CI, -1.13 to 4.70; P = .24; interaction, -1.68; 95% CI, -5.77 to 2.41; P = .42). There were no clinically important between-group differences for secondary variables.CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, parent-led, infant-directed singing did not have clinically important effects on mother-infant bonding, but was safe and well-accepted.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03564184.
AB - IMPORTANCE: Parent-infant bonding contributes to long-term infant health but may be disrupted by preterm birth.OBJECTIVE: To determine if parent-led, infant-directed singing, supported by a music therapist and initiated in the neonatal intensive care unit (NICU), improves parent-infant bonding at 6 and 12 months.DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted in level III and IV NICUs in 5 countries between 2018 and 2022. Eligible participants were preterm infants (under 35 weeks' gestation) and their parents. Follow-up was conducted across 12 months (as part of the LongSTEP study) at home or in clinics. Final follow-up was conducted at 12 months' infant-corrected age. Data were analyzed from August 2022 to November 2022.INTERVENTION: Participants randomized to music therapy (MT) plus standard care or standard care alone during NICU admission, or to MT plus standard care or standard care alone postdischarge, using computer-generated randomization (ratio 1:1, block sizes of 2 or 4 varying randomly), stratified by site (51 allocated to MT NICU, 53 to MT postdischarge, 52 to both, and 50 to neither). MT consisted of parent-led, infant-directed singing tailored to infant responses and supported by a music therapist 3 times per week throughout hospitalization or 7 sessions across 6 months' postdischarge.MAIN OUTCOME AND MEASURE: Primary outcome was mother-infant bonding at 6 months' corrected age, measured by the Postpartum Bonding Questionnaire (PBQ), with follow-up at 12 months' corrected age, and analyzed intention-to-treat as group differences.RESULTS: Of 206 enrolled infants with 206 mothers (mean [SD] age, 33 [6] years) and 194 fathers (mean [SD] age, 36 [6] years) randomized at discharge, 196 (95.1%) completed assessments at 6 months and were analyzed. Estimated group effects for PBQ at 6 months' corrected age were 0.55 (95% CI, -2.20 to 3.30; P = .70) for MT in the NICU, 1.02 (95% CI, -1.72 to 3.76; P = .47) for MT postdischarge, and -0.20 (95% CI, -4.03 to 3.63; P = .92) for the interaction (12 months: MT in NICU, 0.17; 95% CI, -2.71 to 3.05; P = .91; MT postdischarge, 1.78; 95% CI, -1.13 to 4.70; P = .24; interaction, -1.68; 95% CI, -5.77 to 2.41; P = .42). There were no clinically important between-group differences for secondary variables.CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, parent-led, infant-directed singing did not have clinically important effects on mother-infant bonding, but was safe and well-accepted.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03564184.
KW - Adult
KW - Aftercare
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Infant, Premature
KW - Music Therapy
KW - Parents
KW - Patient Discharge
KW - Premature Birth
UR - http://www.scopus.com/inward/record.url?scp=85160458977&partnerID=8YFLogxK
U2 - 10.1001/jamanetworkopen.2023.15750
DO - 10.1001/jamanetworkopen.2023.15750
M3 - Article
C2 - 37234006
AN - SCOPUS:85160458977
SN - 2574-3805
VL - 6
SP - E2315750
JO - JAMA network open
JF - JAMA network open
IS - 5
ER -