Effects of Music Therapy on Patients with Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.

Abstract

Aim: To systematically assess the therapeutic impact of music interventions on hypertensive disorders of pregnancy (HDP). Design: Systematic review and meta-analysis. Methods: A comprehensive search of various databases, such as PubMed, Embase, Cochrane Library, Web of Science, Scopus, CINAHL, EBSCO, Chinese National Knowledge Infrastructure, China Biomedical Literature Database, and Foreign Medical Literature Retrieval Service, was conducted to identify randomized controlled trials (RCTs) investigating the impact of music therapy on HDP from their inception through March 2024. Two independent reviewers performed study selection, data extraction, and risk-of-bias assessment using RoB 2. Statistical analyses were conducted in STATA 17, with evidence certainty graded using Grading of Recommendations Assessment, Development, and Evaluation. The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was prospectively registered in PROSPERO. Results: The meta-analysis included 14 RCTs comprising 1,477 participants. Five separate meta-analyses were conducted to compare the efficacy of music therapy versus standard care. Moderate-quality evidence from randomized trials demonstrated significant reductions associated with music therapy in systolic blood pressure (mean difference [MD] = -10.55 mmHg, 95% confidence interval [CI]: -13.86 to -7.24, p < 0.05), diastolic blood pressure (MD = -8.14 mmHg, 95% CI: -10.59 to -5.58, p < 0.05), sleep quality in patients with hypertension (MD = -1.95 points, 95% CI: -2.41 to -1.49, p < 0.05), and depression (MD = -7.80 points, 95% CI: -9.97 to -5.64, p < 0.001). Low-quality evidence suggested a modest improvement in anxiety (MD = -7.24 points, 95% CI: -8.84 to -5.64, p < 0.05). No publication bias was found in the comprehensive analysis results (all p > 0.1). Conclusion: Our systematic review suggests that adjunctive music therapy provides clinically relevant benefits for controlling systolic and diastolic blood pressure and improving psychological outcomes including anxiety, depression, and sleep quality in patients with HDP when compared with standard care alone.