Effect of Listening Music on Nulliparous Singleton Pregnancies Who Underwent Induction of Labor: A Randomized Clinical Trial

Abstract

Objective

A recent randomized clinical trial (RCT) showed that listening to music reduces the pain level and anxiety levels in women with spontaneous labor at term. The effect on pregnant women undergoing induction of labor is still unclear.

This study aimed to test the hypothesis that in nulliparous women with singleton pregnancies, undergoing induction of labor at term, listening to music would reduce the pain level during labor.

Study Design

Parallel group, non-blinded, RCT conducted at a single center in Italy. Nulliparous women with singleton pregnancies and vertex presentation, admitted for induction of labor with either oral or vaginal prostaglandins, between 37^0/7 and 42^0/7 weeks, were randomized in a 1:1 ratio to receive music during induction of labor or no music during induction. The endpoints of the trials were the pain level during induction, and in the active phase of labor, recorded using the visual analog scale for pain, ranging from 0 (no pain) to 10 (unbearable pain). The effect of music use on each outcome was quantified as the mean difference (MD) with a 95% confidence interval (CI).

Results

During the study period, 30 women agreed to take part in the study, underwent randomization, and were enrolled and followed up. Fifteen women were randomized in the music group and 15 in the control group. No patients were lost to follow-up for the primary outcome. Pain level during the induction procedure was 8.8 ± 0.9 in the music group, and 9.8 ± 0.3 in the control group (MD −2.60 points, 95% CI −3.94 to −1.26; p < 0.01). Music during labor and delivery was also associated with decreased anxiety during the induction procedure (MD −3.80 points, 95% CI −5.53 to −2.07; p < 0.01).

Conclusion

In nulliparous women, listening to music during the induction of labor reduces pain and anxiety levels.

Key Points

• Music listening has a modulatory effect on the human stress response.

• Music listening may generate beneficial changes in the autonomic nervous system and the HPA axis activity that should be conducive to the stress recovery process.

• Listening to music during induction of labor resulted in a significant lower pain.

Keywords

music - induction - labor - prostaglandins - pain

Trial Registration

This study was registered with Clinicaltrials.gov (identifier: NCT04662424).

Ethical Approval

This study was approved by the local IRB of the University of Naples Federico II, approval no.: 301/20.

Publication History

Received: 10 July 2024

Accepted: 08 October 2024

Accepted Manuscript online:
09 October 2024

Article published online:
12 November 2024

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