Effects of prenatal oral L-arginine on birth outcomes: a meta-analysis.

2021-11-23
Scientific reports 11(1)
- Eita Goto

PubMed: 34815460
DOI: 10.1038/s41598-021-02182-6

Study Design

Type: Meta-Analysis
Sample size: n = 45
Population: women with a history of poor pregnancy outcomes and at high risk of pre-eclampsia or with pre-eclampsia or gestational or mild chronic hypertension
Methods: meta-analysis of randomised controlled trials examining prenatal oral L-arginine

Rigorous Journal

Adverse birth outcomes are associated with elevated mortality and morbidity rates throughout life. This meta-analysis of randomised controlled trials examined whether prenatal oral L-arginine has effects on birth outcomes. A total of 45 overall good quality studies were extracted from 10 finally eligible articles. In comparison to controls, providing oral L-arginine to women with a history of poor pregnancy outcomes significantly reduced risks of intrauterine growth retardation neonates, pre-term birth and respiratory distress syndrome (n = 7, 3 and 3, respectively) and significantly increased birthweight and gestational age (n = 8 and 5, respectively) L-Arginine significantly increased Apgar score in women at high risk of pre-eclampsia or with pre-eclampsia or gestational or mild chronic hypertension in comparison to controls (n = 4). L-Arginine showed no significant effect on any other outcome examined (n = 2). The quality of evidence was at least medium or high. Consequently, oral L-arginine may be at least moderately recommended for women with a history of poor pregnancy outcomes and at high risk of pre-eclampsia or with pre-eclampsia or gestational or mild chronic hypertension. However, further studies are required to provide stronger conclusions, partly due to small study effects.

Research Insights

L-Arginine→Increased Apgar Score
L-Arginine significantly increased Apgar score in women at high risk of pre-eclampsia or with pre-eclampsia or gestational or mild chronic hypertension in comparison to controls
Effect
Beneficial
Effect size
Small
L-Arginine→Increased Birth Weight
significantly increased birthweight and gestational age (n = 8 and 5, respectively)
Effect
Beneficial
Effect size
Small
L-Arginine→Increased Gestational Age
significantly increased birthweight and gestational age (n = 8 and 5, respectively)
Effect
Beneficial
Effect size
Small
L-Arginine→Reduced Intrauterine Growth Retardation Risk
In comparison to controls, providing oral L-arginine to women with a history of poor pregnancy outcomes significantly reduced risks of intrauterine growth retardation neonates, pre-term birth and respiratory distress syndrome (n = 7, 3 and 3, respectively)
Effect
Beneficial
Effect size
Small
L-Arginine→Reduced Preterm Births
In comparison to controls, providing oral L-arginine to women with a history of poor pregnancy outcomes significantly reduced risks of intrauterine growth retardation neonates, pre-term birth and respiratory distress syndrome (n = 7, 3 and 3, respectively)
Effect
Beneficial
Effect size
Small
L-Arginine→Reduced Respiratory Distress Syndrome
In comparison to controls, providing oral L-arginine to women with a history of poor pregnancy outcomes significantly reduced risks of intrauterine growth retardation neonates, pre-term birth and respiratory distress syndrome (n = 7, 3 and 3, respectively)
Effect
Beneficial
Effect size
Small