To reduce mortality occurrence on the day of birth, it is recommended to evaluate the health of the fetus during pregnancy. The most widely used technique in most centers as the ideal screening for fetal health assessment is non-stress test. Due to the fact that reducing fetal movement is one of the immediate symptoms of fetal death, this study was conducted to determine the effect of music on fetal movement during non-stress test.


 

This randomized double-blind clinical trial was performed on 160 first-time pregnant women aged 37-40 weeks who had referred to Fatemieh Hospital in Hamadan, Iran, with a complaint of reduced fetal movement in 2019. Individuals were randomly assigned to two control and experimental groups of 80. In the experimental group, 30 minutes of intervention was performed by listening to non-verbal music, but in the control group, no intervention was performed. Data analysis was performed using SPSS 20 and Chi-square test, Mann-Whitney U test and T test. P-value<0.05 was considered significant.

The aim of this study was to investigate the effect of music on fetal movements during pregnancy in Fatemieh Hospital in Hamadan in 2019. The results of this study showed that listening to music improved the number of fetal movements and the number of reactive tests and reduced the number of false positive test cases.
 In this regard, the results of the present study with Dolker study entitled "The effect of music on instinct and maternal anxiety" which examined 100 pregnant women aged 31-32 weeks in Turkey were not consistent in increasing the number of fetal movements (P=0.88) and also about the number of fetal heart rate in the music group was increased compared to the control group (P=0.60) and was not consistent with the present study. Because gestational age affects the fetal heart rate, this discrepancy appears to be due to differences in gestational age. In the study, the intervention was performed on women aged 32-41 weeks, while in the present study, the intervention was performed on pregnant women at 37-40 weeks. However, there was a significant increase in the number of reaction tests in the music group compared with the control group (P=0.001) and was consistent with the present study. Also, there was a significant reduction in the number of non-reactive tests in the music group compared with the control group with the present study (P<0.001) [17].
In a study by Pirhadi et al. entitled "The effect of vibroacoustic stimulation and music on fetal movement" on 64 pregnant women aged 32-36 weeks, listening to music with a significant difference more than vibroacoustic increased fetal movement and increased maternal perception of fetal movement (P<0.05) which was consistent with the present study in terms of increasing fetal movements [20].
In the study of Akbarzade et al. entitled “The effect of maternal relaxation training on reactivity of non-stress test, Basal fetal heart rate, and number of fetal heart accelerations: a randomized controlled trial”, the difference was significant meaning a significant increase in the number of fetal movements in was observed in the music group compared with the control group which was consistent with the present study (P=0.001) [16].
A randomized clinical trial in Korea by Oh Moh in 2016 entitled "Effect of music intervention on maternal anxiety and fetal heart rate pattern during non-stress test" was performed on 60 pregnant women aged 28-40 weeks in two groups of 30 music and control. The number of fetal movements in the music group was 12.95 ± 8.87 and in the control group was 11.40 ± 8.29 and there was no significant difference (P=0.29) [19]. This discrepancy seems to be due to the difference in the duration of listening to music. In the mentioned study, music was heard for 10 minutes in the second half of the instrument in the music group, while in the present study, music was heard for 30 minutes.
In a single-blind randomized clinical trial conducted by Khoshkholgh et al. in Shiraz on 213 pregnant women aged 37-41 weeks, there was no significant difference in the change of fetal heart rate between the intervention and control groups (P>0.05) and it was consistent with the present study [21].

 

Music can improve fetal movements and increase the number of reactive tests.

 

The present study is part of the master's thesis approved by the Graduate Council of Hamadan University of Medical Sciences, which was approved by the ethics committee with the code ethics IR.UMSHA.REC.1398.426 on 31/6/1398 and is registered in the clinical trial system with the code IRCT20120215009014N319. We would like to thank the esteemed professors of the School of Nursing and Midwifery of Hamadan University of Medical Sciences, and the staff of Fatemieh Hospital in Hamadan, all the colleagues and loved ones who participated in this research and helped us.

 

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.