Effects of white noise on preterm infants in the neonatal intensive care unit: A meta-analysis of randomised controlled trials.
Qing Zhang, Qiugui Huo, Peizhen Chen and 2 others
PMID 38268285WHAT IT FOUND
White noise in the NICU reduced pain scores and improved heart rate, respiratory rate, and oxygen saturation in preterm infants.
Weight gain also increased, but only two small studies measured it. Most included trials had high risk of bias and extreme inconsistency between results.
Key findings
01White noise significantly reduced pain levels in preterm infants compared with control groups.
02White noise significantly improved heart rate, respiratory rate, and oxygen saturation, though all showed high heterogeneity.
03White noise increased weight gain, but this result rests on only two studies with a combined sample of 129 infants.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All included studies were rated high risk of bias for performance bias because blinding to sound is not feasible. There was extreme statistical heterogeneity for pain and all vital sign outcomes, meaning the studies varied so widely that a single pooled estimate is difficult to trust. The weight gain finding relies on only two small studies from the same research group. Sensitivity analyses showed that the heart rate benefit disappeared for very preterm and very low birth weight infants, suggesting the effect is not consistent across all NICU populations. Publication bias could not be assessed because fewer than ten studies were included. The trials were conducted only in Turkey and China, limiting generalisability to other healthcare settings. Optimal duration and frequency of white noise exposure were not established by the included studies.
Declared interests
The authors declared no conflicts of interest. The work was funded by government science and technology projects in Suzhou, Jiangsu Province, China.
The easy way to misread this
Do not assume white noise works equally well for all preterm infants. The pooled heart rate benefit was unstable and disappeared in sensitivity analyses for very preterm and very low birth weight infants, and the weight gain evidence rests on only two small studies with high risk of bias.