母親聲音錄音暴露對早產兒生命徵象與發展之影響

The Effect of Exposure to Taped Maternal Voice on Vital Signs and Development in Preterm Infants

胎兒在母親子宮内時，可透過母親聲音及活動的感覺接收多元的感官刺激，但早產兒在孕程發育後期即失去與母親聲音的聯繫，許多文獻陸續證實接觸母親聲音有助於新生兒發展，相關研究亦擴展至早產兒族群，但研究結果仍較分歧。故本研究目的為整合所選取的實驗性研究進行系統性文獻回顧，以統整介入母親聲音錄音檔對於早產兒發展成效之實證，搜尋1996年至2016年7月前發表的中、英文文獻，於華藝線上圖書館、台灣博碩士論文網、The Cochrane Library、PubMed、Medline、ProQuest等六個資料庫中搜尋，最後共得7篇實驗性研究。研究結果發現，介入母親聲音之早產兒雙側大腦聽覺皮質結構發育較大、餵養不耐受情形減少、較快接受全腸道營養餵食、33週以上早產兒發生心肺不良事件較低，而對於早產兒住院天數、體重、疼痛指數、血氧飽和度則無助益，另外，心跳速率的影響目前未有一致結論。本研究結果期可作為臨床早產兒照護之措施依據。

In the normal uterine environment, maternal sounds and movement provide multimodal sensory stimulations for the developing fetus. However, the preterm infants are deprived of the contact with their mother’s voice. Many previous studies support the effect of exposure to maternal voice in full-term infants. The study participants also extend to preterm infants but the results are inconsistent. The aim of the study was to perform a systematic review to summarize the effectiveness of exposure to taped maternal voice on developmental outcomes in preterm infants. Literature search was based on Airiti Library, National Digital Library of Theses in Taiwan, The Cochrane Library, PubMed, MEDLINE, and ProQuest. The search was limited to articles published between 1996 and July, 2016. Seven experimental studies met the inclusion criteria and were selected for further analysis. Results showed that preterm infants exposed to maternal sounds had a significantly larger auditory cortex bilaterally, fewer episodes of feeding intolerance and achieved full enteral feeds quicker compared to the control group. Moreover, when infants ≧33 weeks gestation, lower frequency of cardiorespiratory events was observed during exposure to taped maternal voice. There were no significant differences between the 2 groups on the length of hospital stays, body weight, pain score, and oxygen saturation. However, the effect of exposure to maternal voice on heart rate was inconclusive. Results of the study may be used as a reference for promoting developmental outcomes of preterm infants for clinical practice.