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Open Access 01-12-2018 | Research article

Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study

Authors: Philip Hepp, Carsten Hagenbeck, Julius Gilles, Oliver T. Wolf, Wolfram Goertz, Wolfgang Janni, Percy Balan, Markus Fleisch, Tanja Fehm, Nora K. Schaal

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Abstract

Background

Stress and anxiety during pregnancy and childbirth have negative consequences for both mother and child. There are indications that music has a positive effect in this situation. The present study investigates the influence of music during the caesarean on anxiety and stress of the expectant mother.

Methods

The SAMBA study is a single-centre, controlled, randomized study including 304 patients. Women in the intervention group heard music via loudspeakers from one of four self-selected genres. The control group had standard treatment without music. The caesarean was performed in regional Anesthesia. At admission, at skin incision, during skin suture and two hours after completion of surgery, different subjective (State-Trait Anxiety Inventory, visual analogue scale for anxiety) and objective parameters (salivary cortisol/amylase, heart rate, blood pressure) were collected. Mixed-factorial Analysis of variances as well as independent sample t-tests were applied for data analysis.

Results

At skin suture, significantly lower anxiety levels were reported in the intervention group regarding State anxiety (31.56 vs. 34.41; p = .004) and visual analogue scale for anxiety (1.27 vs. 1.76; p = .018). Two hours after surgery, the measured visual analogue scale for anxiety score in the intervention group was still significantly lower (0.69 vs. 1.04; p = .018). The objective parameters showed significant differences between the groups in salivary cortisol increase from admission to skin suture (12.29 vs. 16.61 nmol/L; p = .043), as well as systolic blood pressure (130.11 vs. 136.19 mmHg; p = .002) and heart rate (88.40 vs. 92.57/min; p = .049) at skin incision.

Conclusions

Music during caesarean is an easy implementable and effective way of reducing stress and anxiety of the expectant mother.

Trial registration

German registry for clinical trials (DRKS00007840). Registered 16/06/2015. Retrospectively registered.

Blüml V, Stammler-Safar M, Reitinger AK, Resch I, Naderer A, Leithner K. A qualitative approach to examine women’s experience of planned cesarean. J Obstet Gynecol Neonatal Nurs. 2012;41:E82–90. https://doi.org/10.1111/j.1552-6909.2012.01398.x.CrossRefPubMed

Hepp P, Hagenbeck C, Burghardt B, Jaeger B, Wolf OT, Fehm T, et al. Measuring the course of anxiety in women giving birth by caesarean section: a prospective study. BMC Pregnancy Childbirth. 2016;16:113. https://doi.org/10.1186/s12884-016-0906-z.CrossRefPubMedPubMedCentral

Mulder EJH, Robles de Medina PG, Huizink AC, den Bergh BRH V, Buitelaar JK, GHA V. Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev. 2002;70:3–14 http://www.ncbi.nlm.nih.gov/pubmed/12441200. Accessed 15 Oct 2017.CrossRefPubMed

O’Donnell KJ, Glover V, Barker ED, O’Connor TG. The persisting effect of maternal mood in pregnancy on childhood psychopathology. Dev Psychopathol. 2014;26:393–403. https://doi.org/10.1017/S0954579414000029.CrossRefPubMed

Good M. Effects of relaxation and music on postoperative pain: a review. J Adv Nurs. 1996;24:905–14 http://www.ncbi.nlm.nih.gov/pubmed/8933249. Accessed 15 Oct 2017.CrossRefPubMed

Powell R, Scott NW, Manyande A, Bruce J, Vögele C, Byrne-Davis LM, et al. Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. In: Powell R, editor. Cochrane Database of Systematic Reviews. Chichester: John Wiley & Sons, Ltd; 2016. p. CD008646. https://doi.org/10.1002/14651858.CD008646.pub2.CrossRef

Dewey KG. Maternal and fetal stress are associated with impaired lactogenesis in humans. J Nutr. 2001;131:3012S–5S http://www.ncbi.nlm.nih.gov/pubmed/11694638. Accessed 15 Oct 2017.CrossRefPubMed

Grajeda R, Pérez-Escamilla R. Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women. J Nutr. 2002;132:3055–60 http://www.ncbi.nlm.nih.gov/pubmed/12368395. Accessed 15 Oct 2017.CrossRefPubMed

Conrad C. Music for healing: from magic to medicine. Lancet (London, England). 2010;376:1980–1 http://www.ncbi.nlm.nih.gov/pubmed/21171230. Accessed 15 Oct 2017.CrossRef

10.

Goertz W, Dominick K, Heussen N, Vom dahl J. Music in the cath lab: who should select it. Clin Res Cardiol. 2011;100:395–402. https://doi.org/10.1007/s00392-010-0256-1.CrossRefPubMed

11.

Smolen D, Topp R, Singer L. The effect of self-selected music during colonoscopy on anxiety, heart rate, and blood pressure. Appl Nurs Res. 2002;15:126–36 http://www.ncbi.nlm.nih.gov/pubmed/12173164. Accessed 14 Oct 2015.CrossRefPubMed

12.

Koelsch S, Fuermetz J, Sack U, Bauer K, Hohenadel M, Wiegel M, et al. Effects of music listening on cortisol levels and Propofol consumption during spinal anesthesia. Front Psychol. 2011;2:58. https://doi.org/10.3389/fpsyg.2011.00058.CrossRefPubMedPubMedCentral

13.

Angioli R, De Cicco NC, Plotti F, Cafà EV, Dugo N, Damiani P, et al. Use of music to reduce anxiety during office hysteroscopy: prospective randomized trial. J Minim Invasive Gynecol. 2014;21:454–9. https://doi.org/10.1016/j.jmig.2013.07.020.CrossRefPubMed

14.

Hole J, Hirsch M, Ball E, Meads C. Music as an aid for postoperative recovery in adults: a systematic review and meta-analysis. Lancet. 2015;386:1659–71. https://doi.org/10.1016/S0140-6736(15)60169-6.CrossRefPubMed

15.

Laopaiboon M, Lumbiganon P, Martis R, Vatanasapt P, Somjaivong B. Music during caesarean section under regional anaesthesia for improving maternal and infant outcomes. Cochrane Database Syst Rev. 2009:CD006914. https://doi.org/10.1002/14651858.CD006914.pub2.

16.

Li Y, Dong Y. Preoperative music intervention for patients undergoing cesarean delivery. Int J Gynaecol Obstet. 2012;119:81–3. https://doi.org/10.1016/j.ijgo.2012.05.017.CrossRefPubMed

17.

Kushnir J, Friedman A, Ehrenfeld M, Kushnir T. Coping with preoperative anxiety in cesarean section: physiological, cognitive, and emotional effects of listening to favorite music. Birth. 2012;39:121–7. https://doi.org/10.1111/j.1523-536X.2012.00532.x.CrossRefPubMed

18.

Chang S, Chen C. Effects of music therapy on women’s physiologic measures, anxiety, and satisfaction during cesarean delivery. Res Nurs Health. 2005;28:453–61. https://doi.org/10.1002/nur.20102.CrossRefPubMed

19.

Reza N, Ali SM, Saeed K, Abul-Qasim A, Reza TH. The impact of music on postoperative pain and anxiety following cesarean section. Middle East J Anaesthesiol. 2007;19:573–86 http://www.ncbi.nlm.nih.gov/pubmed/18044285. Accessed 15 Oct 2017.PubMed

20.

Laux L, Glanzmann P, Schaffner P, Spielberger CD. Das State-Trait- Angstinventar (STAI) (Beltz-Test). Beltz Test GmbH: Göttingen; 1981.

21.

Strahler J, Skoluda N, Kappert MB, Nater UM. Simultaneous measurement of salivary cortisol and alpha-amylase: application and recommendations. Neurosci Biobehav Rev. 2017;83:657–77. https://doi.org/10.1016/j.neubiorev.2017.08.015.CrossRefPubMed

22.

Schoofs D, Wolf OT. Are salivary gonadal steroid concentrations influenced by acute psychosocial stress? A study using the Trier social stress test (TSST). Int J Psychophysiol. 2011;80:36–43. https://doi.org/10.1016/j.ijpsycho.2011.01.008.CrossRefPubMed

23.

Nilsson U. The anxiety- and pain-reducing effects of music interventions: a systematic review. AORN J. 2008;87:780–807. https://doi.org/10.1016/j.aorn.2007.09.013.CrossRefPubMed

24.

Petrakova L, Doering BK, Vits S, Engler H, Rief W, Schedlowski M, et al. Psychosocial stress increases salivary alpha-amylase activity independently from plasma noradrenaline levels. PLoS One. 2015;10:e0134561. https://doi.org/10.1371/journal.pone.0134561.CrossRefPubMedPubMedCentral

25.

Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149–60. https://doi.org/10.3758/BRM.41.4.1149.CrossRefPubMed

26.

Ikonomidou E, Rehnström A, Naesh O. Effect of music on vital signs and postoperative pain. AORN J. 2004;80:269–74, 277–8. http://www.ncbi.nlm.nih.gov/pubmed/15382598 Accessed 15 Oct 2017.CrossRefPubMed

27.

Khalfa S, Bella SD, Roy M, Peretz I, Lupien SJ. Effects of relaxing music on salivary cortisol level after psychological stress. Ann N Y Acad Sci. 2003;999:374–6 http://www.ncbi.nlm.nih.gov/pubmed/14681158. Accessed 15 Oct 2017.CrossRefPubMed

28.

Zengin S, Kabul S, Al B, Sarcan E, Doğan M, Yildirim C. Effects of music therapy on pain and anxiety in patients undergoing port catheter placement procedure. Complement Ther Med. 2013;21:689–96. https://doi.org/10.1016/j.ctim.2013.08.017.CrossRefPubMed

29.

van Stegeren AH, Wolf OT, Kindt M. Salivary alpha amylase and cortisol responses to different stress tasks: impact of sex. Int J Psychophysiol. 2008;69:33–40.CrossRefPubMed

30.

Orbach-Zinger S, Ginosar Y, Elliston J, Fadon C, Abu-Lil M, Raz A, et al. Influence of preoperative anxiety on hypotension after spinal anaesthesia in women undergoing caesarean delivery. Br J Anaesth. 2012;109:943–9. https://doi.org/10.1093/bja/aes313.CrossRefPubMed

31.

Sadi H, Finkelman M, Rosenberg M. Salivary cortisol, salivary alpha amylase, and the dental anxiety scale. Anesth Prog. 2013;60:46–53. https://doi.org/10.2344/0003-3006-60.2.46.CrossRefPubMedPubMedCentral

32.

Koelsch S, Jäncke L. Music and the heart. Eur Heart J. 2015;36:3043–9. https://doi.org/10.1093/eurheartj/ehv430.CrossRefPubMed

33.

Koelsch S. Brain correlates of music-evoked emotions. Nat Rev Neurosci. 2014;15:170–80. https://doi.org/10.1038/nrn3666.CrossRefPubMed

34.

Bernardi L, Porta C, Casucci G, Balsamo R, Bernardi NF, Fogari R, et al. Dynamic interactions between musical, cardiovascular, and cerebral rhythms in humans. Circulation. 2009;119:3171–80 http://www.ncbi.nlm.nih.gov/pubmed/19569263. Accessed 22 Oct 2017.CrossRefPubMed

35.

Bernatzky G, Kreutz G. Musik und Medizin Chancen für Therapie, Prävention und Bildung. Vienna: Springer; 2015.

36.

Thaut MH, McIntosh GC, Hoemberg V. Neurobiological foundations of neurologic music therapy: rhythmic entrainment and the motor system. Front Psychol. 2014;5:1185. https://doi.org/10.3389/fpsyg.2014.01185.CrossRefPubMed

37.

Weldon S-M, Korkiakangas T, Bezemer J, Kneebone R. Music and communication in the operating theatre. J Adv Nurs. 2015;71:2763–74. https://doi.org/10.1111/jan.12744.CrossRefPubMed

Title: Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study
Authors: Philip Hepp
Carsten Hagenbeck
Julius Gilles
Oliver T. Wolf
Wolfram Goertz
Wolfgang Janni
Percy Balan
Markus Fleisch
Tanja Fehm
Nora K. Schaal
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-018-2069-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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