Impact of Structured Music Interventions on Stress Parameters in Neonates: A Sequential Within-subject Quasi-experimental Study

Background Neonates in the neonatal intensive care unit (NICU) are frequently exposed to stressful stimuli, which may disrupt neurophysiological regulation. Music therapy has emerged as a nonpharmacological intervention to promote autonomic stability and behavioral regulation. This study aimed to evaluate the effects of four distinct music types on physiological parameters and behavioral states in neonates. Methods In this prospective quasi-experimental study, 103 clinically stable neonates (≥29 weeks’ gestation) admitted to a Level III NICU were sequentially exposed to four 45-min music interventions ( Om chanting, Gayatri Mantra , Garbh Sanskar compositions, and maternal lullabies) with 2-h washout periods between sessions. Heart rate (HR), respiratory rate (RR), oxygen saturation (SpO 2 ), and mean arterial pressure (MAP) were recorded before and during each intervention. Behavioral state assessments (quiet sleep, active sleep, awake/crying) were conducted using the Preterm Infant Behavioral States Classification Tool. Repeated-measures analysis of variance and paired t -tests were used for statistical analysis. Results All four music types significantly reduced HR and RR compared to baseline ( P < .001). SpO 2 and MAP remained stable across interventions. Garbh Sanskar and maternal lullabies showed slightly greater reductions in HR and RR. Behavioral assessments demonstrated increased quiet sleep and decreased awake/crying time following these two interventions. Conclusion Music interventions, including traditional chants and lullabies, safely reduce physiological stress and improve behavioral regulation in NICU neonates. These findings support integrating structured music therapy into neonatal care. Further randomized controlled trials are warranted to assess comparative efficacy and long-term developmental impacts.