Abstract Introduction: Evidence supporting the benefits of music therapy for preterm infants during neonatal care is growing. This study aimed to compare the effects of live-performed music therapy (MT) on physiological and behavioral responses to storytelling (ST) as an alternative caregiving intervention. Methods: The study was conducted as a randomized controlled trial (RCT), enrolling preterm infants born from 32+0 to 36+6 weeks of gestation. Infants were block-randomized to either receive MT or ST. Both interventions were performed live and provided three to four times per week on average. Vital signs and behavioral state (assessed using the COMFORTneo scale) were documented before, during, and after each intervention. Results: Sixty preterm infants were enrolled in the study: 30 received MT and 30 received ST. We observed positive effects on vital signs and behavioral state in both groups, although the effects were importantly less pronounced in the ST group compared to the MT group. Heart rate decreased during both MT and ST interventions (mean difference (MD) (baseline–after): MT -9.90 bpm (95% CI -11.14 to -8.66); ST -2.85 bpm (-3.79 to -1.92)). Respiratory rate also decreased for both groups (MD: MT -8.60 breaths/min (-9.60 to -7.60); ST -2.49 breaths/min (-3.30 to -1.68)). Oxygen saturation increased (MD: MT +1.01% (0.82 to 1.20); ST +0.25% (0.11 to 0.39)). The COMFORTneo score decreased (MD: MT -5.40 (-5.95 to -4.86); ST -2.26 (-2.74 to -1.77)). Conclusion: Both, music therapy and storytelling, positively impacted the immediate well-being of preterm infants. However, the benefits of live music therapy on physiological and behavioral parameters compared to storytelling as a caregiving alternative were significantly higher.
Weinkoetz et al. (2025) studied this question.