Abstract：
OBJECTIVE: Mental health affects maternal well-being and indirectly affects the development of fetal brain structures and motor and cognitive skills of the offspring up to adulthood. This study aimed to identify specific characteristics of music interventions that improve validated maternal outcomes.
METHODS: Randomized controlled trials and systematic reviews investigating music interventions during pregnancy were identified from the start of data sources up to December 2023 using MEDLINE, the Cochrane Central Register of Controlled Trials, or Web of Science.
METHODS: Using Covidence, 2 reviewers screened for randomized controlled trials with ≥3 music interventions during pregnancy and applied either the Perceived Stress Scale score, State-Trait Anxiety Inventory score, Edinburgh Postnatal Depression Scale score, or blood pressure as outcomes.
METHODS: The Cochrane risk-of-bias tool 2, the checklist to assess Trustworthiness in RAndomised Clinical Trials, and the reversed Cohen d were applied. This review was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42022299950).
RESULTS: From 251 detected records, 14 randomized controlled trials and 2375 pregnancies were included. Music interventions varied from 3 to 84 active or passive sessions with either patient-selected or preselected music and a duration of 10 to 60 minutes per session. Thereby, 2 of 4 studies observed a significant decrease in the Perceived Stress Scale, 8 of 9 studies observed a significant decrease in the State-Trait Anxiety Inventory, and 3 of 4 studies observed a significant decrease in the Edinburgh Postnatal Depression Scale. Blood pressure was significantly reduced in 3 of 4 randomized controlled trials. The Cochrane risk-of-bias tool 2 was \"high\" in 5 of 14 studies or \"with concerns\" in 9 of 14 studies. Stratifying the Cohen d in 14 intervention arms suggested a big effect in 234 of 469 mothers on blood pressure and in 244 of 489 mothers on maternal anxiety and a medium effect in 284 of 529 mothers on maternal anxiety. Small or very small effects on blood pressure, the Edinburgh Postnatal Depression Scale, and the Perceived Stress Scale were observed in 35 of 70, 136 of 277, and 374 of 784 mothers-to-be, respectively.
CONCLUSIONS: Our study found a general positive effect of music interventions on maternal stress resilience. This was independent of the music but was influenced by the frequency and empathy of the performances. How far music interventions may improve postnatal development and skills of the offspring should be increasingly evaluated with follow-ups to interrupt vicious epigenetic circles during global pandemics, violent conflicts, and natural catastrophes. El resumen está disponible en Español al final del artículo.
METHODS: Randomized controlled trials and systematic reviews investigating music interventions during pregnancy were identified from the start of data sources up to December 2023 using MEDLINE, the Cochrane Central Register of Controlled Trials, or Web of Science.
METHODS: Using Covidence, 2 reviewers screened for randomized controlled trials with ≥3 music interventions during pregnancy and applied either the Perceived Stress Scale score, State-Trait Anxiety Inventory score, Edinburgh Postnatal Depression Scale score, or blood pressure as outcomes.
METHODS: The Cochrane risk-of-bias tool 2, the checklist to assess Trustworthiness in RAndomised Clinical Trials, and the reversed Cohen d were applied. This review was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42022299950).
RESULTS: From 251 detected records, 14 randomized controlled trials and 2375 pregnancies were included. Music interventions varied from 3 to 84 active or passive sessions with either patient-selected or preselected music and a duration of 10 to 60 minutes per session. Thereby, 2 of 4 studies observed a significant decrease in the Perceived Stress Scale, 8 of 9 studies observed a significant decrease in the State-Trait Anxiety Inventory, and 3 of 4 studies observed a significant decrease in the Edinburgh Postnatal Depression Scale. Blood pressure was significantly reduced in 3 of 4 randomized controlled trials. The Cochrane risk-of-bias tool 2 was \"high\" in 5 of 14 studies or \"with concerns\" in 9 of 14 studies. Stratifying the Cohen d in 14 intervention arms suggested a big effect in 234 of 469 mothers on blood pressure and in 244 of 489 mothers on maternal anxiety and a medium effect in 284 of 529 mothers on maternal anxiety. Small or very small effects on blood pressure, the Edinburgh Postnatal Depression Scale, and the Perceived Stress Scale were observed in 35 of 70, 136 of 277, and 374 of 784 mothers-to-be, respectively.
CONCLUSIONS: Our study found a general positive effect of music interventions on maternal stress resilience. This was independent of the music but was influenced by the frequency and empathy of the performances. How far music interventions may improve postnatal development and skills of the offspring should be increasingly evaluated with follow-ups to interrupt vicious epigenetic circles during global pandemics, violent conflicts, and natural catastrophes. El resumen está disponible en Español al final del artículo.
摘要：
目的：心理健康会影响母亲的幸福感，并间接影响胎儿大脑结构的发育以及后代直至成年的运动和认知技能。主要目标是找到音乐干预措施的具体特征，以改善已验证的产妇结局。
方法：从数据源开始到2023年12月，使用MEDLINE确定了研究怀孕期间音乐干预的随机对照试验（RCT）和系统评价，中部,或WEB的科学。
方法：使用COVIDENCE，两名审查人员筛选了怀孕期间使用3次以上音乐干预的RCT，这些RCT应用了感知压力量表（PSS），状态特质焦虑清单(STAI)，爱丁堡产后抑郁症量表（EPDS），或血压（BP）作为结果。
方法：修订后的Cochrane偏差风险工具(RoB2)，评估RCT中可信度的清单(TRACT)，和反向科恩的d被应用。该评论通过PROSPEROCRD42022299950注册。
结果：从检测到的251条记录中，包括14例RCT和2375例妊娠。音乐干预从总共3到84个主动或被动会话，患者或预先选择的音乐，每个会话的持续时间为10到60分钟。因此，2/4研究观察到PSS显着下降，8/9STAI显著下降，3/4EPDS显着降低；3/4RCTs中BP显着降低。RoB2在5/14研究中“高”，或在9/14研究中“有担忧”。对14个干预组的科恩d进行分层表明，234/469名母亲对血压有很大影响，244/489名母亲对母亲焦虑有很大影响，284/529名母亲对母亲焦虑有中等影响。在35/70中观察到对BP的小或非常小的影响，在136/277中观察到对EPDS的影响，在374/784准妈妈中观察到对PSS的影响。
结论：我们发现音乐干预对产妇压力复原力具有普遍的积极影响。这与音乐本身无关，但受到表演频率和同情心的影响。在全球大流行时期，音乐干预可以在多大程度上改善后代的产后发育和技能，应该越来越多地进行后续评估，以中断恶性表观遗传圈。暴力冲突,和自然灾害。
方法：从数据源开始到2023年12月，使用MEDLINE确定了研究怀孕期间音乐干预的随机对照试验（RCT）和系统评价，中部,或WEB的科学。
方法：使用COVIDENCE，两名审查人员筛选了怀孕期间使用3次以上音乐干预的RCT，这些RCT应用了感知压力量表（PSS），状态特质焦虑清单(STAI)，爱丁堡产后抑郁症量表（EPDS），或血压（BP）作为结果。
方法：修订后的Cochrane偏差风险工具(RoB2)，评估RCT中可信度的清单(TRACT)，和反向科恩的d被应用。该评论通过PROSPEROCRD42022299950注册。
结果：从检测到的251条记录中，包括14例RCT和2375例妊娠。音乐干预从总共3到84个主动或被动会话，患者或预先选择的音乐，每个会话的持续时间为10到60分钟。因此，2/4研究观察到PSS显着下降，8/9STAI显著下降，3/4EPDS显着降低；3/4RCTs中BP显着降低。RoB2在5/14研究中“高”，或在9/14研究中“有担忧”。对14个干预组的科恩d进行分层表明，234/469名母亲对血压有很大影响，244/489名母亲对母亲焦虑有很大影响，284/529名母亲对母亲焦虑有中等影响。在35/70中观察到对BP的小或非常小的影响，在136/277中观察到对EPDS的影响，在374/784准妈妈中观察到对PSS的影响。
结论：我们发现音乐干预对产妇压力复原力具有普遍的积极影响。这与音乐本身无关，但受到表演频率和同情心的影响。在全球大流行时期，音乐干预可以在多大程度上改善后代的产后发育和技能，应该越来越多地进行后续评估，以中断恶性表观遗传圈。暴力冲突,和自然灾害。
