Life vs. Digital Music Interventions Performed by Professionals Throughout Pregnancy to Increase Mental Health for Mothers and Their Offspring

Short-term differences in affection measured immediately before and after all interventions by the PANAS Test (Positive and Negative Affect Schedule). Each time the same six factors are asked in the PANAS. The minimum score is 3 (low affect),the maximum score is 15 (high affect).

Short-term differences in affection measured immediately before and after all interventions by the differences in cortisol level from buccal swabs, measured twice before and after concerts during pregnancy. In the beginning and at the end of the study.

Changes in maternal mental health throughout pregnancy of validated psychological questionnaires such as PSS (Perceived Stress Scale) from the start of recruitment up to delivery. Minimum score is zero (0) and shows low stress. The maximum score is forty (40) considered as high perceived stress.

Changes in maternal mental health throughout pregnancy of validated psychological questionnaires such as STAI (State Trait Anxiety Inventory) from the start of recruitment up to delivery. The minimal score result is 10, the maximal score result is 80 for each of the two parts (State and Trait).

Changes in maternal mental health throughout pregnancy of validated psychological questionnaires such as EPDS (Edinburgh Postnatal Depression Scale) from the start of recruitment up to delivery. The minimal score result is zero (0), thereby 0-9 points signifies low risk of depression. The maximum score result is thirty (30), with more or equal thirteen (13) points demonstrating a high risk for depression. Ten (10) to twelve (12) signifies moderate risk for depression.

Changes in maternal mental health throughout pregnancy by the concentration of cortisol within maternal hair from the start of recruitment up to delivery.

The perinatal and neonatal outcomes as well as follow-up of the infants by AGES and STAGES after 6 and 12 months. The Ages and Stages Questionnaire (ASQ) is a general developmental screening tool that examines developmental challenges at specific ages. Minimum score result is zero (0) and maximum score result is 300. Characterizing the least and the optimal stages of development.

The Parca-R asked at two years after delivery. PARCA-R stands for Parent Report of Children's Abilities-Revised. It is a parent completed questionnaire that can be used to assess children's cognitive and language development at 24 months of age. The minimal value of the PARCA-R score results for a) cognitive and b) language development is zero (0). The maximum of a) is 34 and for b) 50. Thus the minimal value of the total score is zeo (0) and the maximal 84, characterizing the least and the optimal stages of cognitive and verbal development. Within the investigators plan to compare means with ranges to the standards given in the original publication of Johnson et al. (Lancet Child Adolesc Health 2019) and also compare the results of the Live and Digital Group.

Goldsmiths musical sophistication index. The minimal score result is 31, representing poor integration of music at home and maximal score result is 266, representing optimal integration of music in every category.

EEG (electroencephalogram) of newborns after 3-6 months. Thereby validated questionnaires and, optionally, an EEG device are used, with which the children's brain waves are recorded using non-invasive electrodes that make contact with the skin via a warm gel and are fixed in place with a cap (approx. 5 min resting EEG without acoustic stimulation, approx. 10 min EEG when listening to syllable sequences). The meaning of the tracings with respect of later language development has been established by our group before .

More specifically, we shall analyze only brain potentials within event-related EEG-tracings, such as mismatch negativity (MMN). Not according to the frequency spectre such as alpha, beta etc. characteristics.

Telomere length (TL) of the newborns determined at leucocytes in the umbilical blood at birth. Thereby DNA is isolated from whole blood. Leukocyte TL is the most commonly used measure of TL in human epidemiological studies, and it has been postulated that TL dynamics in leukocytes mirror those of the entire hematopoietic stem cell population, the original pool of which is formed early in gestation and serves as the progenitor for cells in all blood lineages.

Relative TL is measured by quantitative polymerase chain reaction (qPCR), expressed as the ratio of telomere to single-copy gene abundance (T/S ratio), as previously described.

Detection of the human placental11β-HSD2 to determine fetal stress during pregnancy.

Placental 11β-HSD2 protein levels are quantified by Western blotting. The polyclonal sheep anti-human 11β-HSD2 antibody (LOT 318564, The Binding Site Group Ltd, Birmingham, UK) is used and tested beforehand in immunohisto-chemistry on 5 μm paraffin embedded placental sections.

The blots are incubated overnight with the 11β-HSD2 antibody at a dilution of 1:1000 in 5% skim milk powder and analyzed on the next day. Each blot is repeated at least three times and included an internal control sample that controlled for inter-blotvariability. Protein results are expressed as ratio of 11β- HSD2, to β-Actin (1:80000, LOT GR67149-2, Abcam plc, Cambridge, UK) and expressed as relative optical density units (ROD).