Impact of live music therapy compared with storytelling on maternal depression and psychological distress in mothers of preterm infants: a secondary analysis of a randomized controlled trial.

introductionMusic therapy in neonatology is becoming increasingly important and is now considered an evidence-based intervention that effectively complements standard medical care for preterm infants and their mothers in accordance with family-centered care. This study aimed to compare the effects of live-performed music therapy (MT) and storytelling (ST) in the neonatal intensive care unit (NICU) on psychological distress and depression among mothers of preterm infants.

methodsThe study was conducted as a secondary analysis of a randomized controlled trial (RCT), enrolling 60 preterm infants born between 32+0 to 36+6 weeks of gestation. Infants were block-randomized 1:1 to receive either MT or ST. Both interventions were delivered live to the preterm infants three to four times per week from birth until hospital discharge from hospital. The degree of depressive symptoms, anxiety and acute stress reactions of their mothers were measured using the German version of the Center for Epidemiologic Studies Depression Scale (CES-D) and the Impact of Event Scale-Revised (IES-R). Assessments were conducted on the first day of delivery prior to randomization (Timepoint 1 [T1]), at infants discharge from hospital (Timepoint 2 [T2]) and around the infants' first birthday (Timepoint 3 [T3]).

resultsThe infants of 30 mothers [mean age 33.8 ± 6.1 years (range 21-47)] received MT and the infants of an additional 30 mothers [mean age 32.9 ± 5.3 years (range 21-45)] received ST. A total of 552 sessions were conducted, including 303 live music therapy sessions with a mean duration of 24 ± 2.5 minutes and 249 live storytelling sessions with a mean duration of 23 ± 4.1 minutes. Mothers whose infants received music therapy demonstrated greater reductions of depressive and stress symptoms between T1 and T2 compared to mothers whose infants received storytelling (MT: CES-D mean difference in total score -22.4, IES-R mean difference of total score -3.9; ST: mean difference in CES-D total score -10.7, mean difference of IES-R total score -1.1). Effect sizes (Cohen's d) for the differences between T1 and T2 were large for total CES-D (1.0) and total IES-R (1.5), but weak for the differences between T1 and T3 (total CES-D 0.4, total IES-R 0.4). The absolute values at T3 did not differ as much as those at T2 between the two groups, but remained slightly more favorable in mothers whose infants received MT (mean total CES-D 6.7, 95% Confidence Interval (CI) 5.9-7.6; mean total IES-R -1.8, 95% CI -2.2-(-1.4)) than in mothers whose infants received ST (mean total CES-D 10.8, 95% CI 9.1-12.4; mean total IES-R -1.7, 95% CI -1.9-(-1.2)). DISCUSSION: These findings indicate that mothers of preterm infants may benefit from music therapy as a supportive, non-medical intervention in alleviating psychological symptoms and distress during their infants' NICU stay and may continue to support maternal well-being in the longer term, up to the infants' first birthday.