The Effect of Nonstress Device Noise Level on Stress Parameters in Primigravid Women: A Randomized Controlled Trial

Ayşenur T., Nuran G., Cihan K., Huri B.

Journal of Midwifery and Women's Health, vol.69, no.2, pp.279-286, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 69 Issue: 2
  • Publication Date: 2024
  • Doi Number: 10.1111/jmwh.13581
  • Journal Name: Journal of Midwifery and Women's Health
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, ASSIA, CINAHL, Gender Studies Database, MEDLINE
  • Page Numbers: pp.279-286
  • Keywords: adrenocorticotropic hormone, cortisol, noise, pregnancy, prenatal care
  • Istanbul Medipol University Affiliated: No


Introduction: This study evaluated the effect of the noise level of the nonstress test (NST) device on stress parameters in primigravid women. Methods: A total of 44 pregnant women participated in a randomized clinical trial between February and October, 2021. The participants were divided randomly into 4 equal groups using an automated web-based randomization system and ensuring allocation concealment: the control group (NST device volume turned off), intervention group I (1-35 dB(A)), intervention group II (36-60 dB(A)), and intervention group III (61 dB(A) and above). A data collection form was used to record personal information and stress parameters. Stress parameters (blood pressure, heart rate, oxygen saturation [SpO2], blood glucose, salivary cortisol, and salivary adrenocorticotropic hormone [ACTH]) levels were measured pretest (0-2 minutes before NST starts), midtest (at 10 minutes of the NST), and posttest (within 0-2 minutes after NST was finished). The study was registered at (identifier: NCT05488704). Results: NST sound levels above 35 dB(A) increased the average cortisol and ACTH levels in the posttest. NST sound levels were positively correlated with posttest cortisol (r =.448) and posttest glucose (r =.302). There was interaction effect on heart rate, glucose, and cortisol level by time, indicating that the intervention groups experienced a significant acceleration in heart rate, glucose, and cortisol level after a noise intervention compared with the control group. Discussion: Midwives should continue applying NST below 36 dB(A), considering the factors that may induce stress during the NST process.