Cerebral oxygenation in preterm infants during maternal singing combined with skin-to-skin care

Background Our aim was to investigate the effect of music therapy in combination with skin-to-skin care (SSC) on regional cerebral oxygenation (rSO 2 ) measured with near-infrared spectroscopy (NIRS) in premature infants and to study physiological stability during the interventions. Methods This was a prospective single-center observational cohort study conducted in a tertiary neonatal intensive care unit. The study consisted of four phases: (1) baseline measurements in an incubator for 30 min; (2) quiet SSC for 30 min (SSC-Pre); (3) SSC with live maternal singing accompanied by live guitar music for 20 min (SSC-Music); (4) final quiet SSC for another 30 min (SSC-Post). Results The primary outcome measure of mean rSO 2 for the 31 preterm infants analyzed showed a significant increase from baseline during SSC-Music (76.87% vs 77.74%, p = 0.04) and SSC-Post (76.87% vs 78.0%, p = 0.03) phases. There were no significant changes observed in heart rate (HR), peripheral oxygen saturation (SpO 2 ), and cerebral fractional tissue oxygen extraction (cFTOE). The coefficient of variation (CV) of rSO 2 and SpO 2 decreased during each intervention phase. Conclusion Combining music therapy with SSC appears to be safe in preterm neonates. The impact of the small increase in rSO 2 and reduced variability of SpO 2 and rSO 2 warrants further investigation. Impact Music therapy combined with skin-to-skin care (SSC) is safe in clinically stable premature infants and could be encouraged as part of developmental care. This is the first report where near-infrared spectroscopy (NIRS) was used to detect the simultaneous effect of music therapy and SSC on cerebral rSO 2 in preterm infants. Music therapy with SSC caused a modest increase in rSO 2 and decreased the coefficient of variation of rSO 2 and peripheral oxygen saturation (SpO 2 ), which suggest short-term benefits for preterm infants.