title: Arginine supplementation for improving maternal and neonatal outcomes in hypertensive disorder of pregnancy: a systematic review.
abstract: OBJECTIVE
  This meta-analysis was performed to assess whether arginine supplementation could reduce preeclampsia or eclampsia incidence and improve the outcomes of hypertensive disorders in pregnancy, and to evaluate the safety of L-arginine supplementation.
  
  
  METHODS
  The Cochrane Central Register of Controlled Trials (2011), MEDLINE (1980-2011) and Embase (1980-2011) were searched through July 2012, and randomized controlled trials (RCTs) comparing intravenous and/or oral L-arginine supplementation with placebo, or RCTs comparing any treatment with arginine were included. Qualities of RCTs were assessed with the Jadad method. Meta-analyses were performed with fixed- or random-effects models according to heterogeneity of studies.
  
  
  RESULTS
  Data from seven RCTs involving 916 patients were enrolled. The meta-analysis showed L-arginine was more effective in reducing preeclampsia or eclampsia incidence (odds ratio 0.384; 95% confidence limits 0.25, 0.58) than the placebo; meanwhile, L-arginine could prolong pregnancy weeks (MD 11.54; 95% CL 5.23, 17.85) than placebo; and its effect on blood pressure was unbalanced (diastolic pressure (MD 4.86; 95% CL 4.19, 5.52) and systolic pressure (MD 3.20; 95% CL -1.54, 7.94)) while the difference in increased neonatal weight (MD 256.24; 95% CL -28.66, 541.13) was not clear. Three of these studies reported some adverse effects, and no teratogenic or lethal effects were noted.
  
  
  CONCLUSIONS
  This study demonstrates L-arginine supplementation is superior to placebo in lowering diastolic pressure and prolonging pregnancy in patients with gestational hypertension with or without proteinuria, but the effect on lowering systolic pressure and increasing neonatal weight was not statistically significant.
authors: 1Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, PR China.
authors: Shunping
authors: S
authors: Gui
authors: Jin
authors: J
authors: Jia
authors: Xiaoyu
authors: X
authors: Niu
authors: Yi
authors: Y
authors: Bai
authors: Heng
authors: H
authors: Zou
authors: Juelin
authors: J
authors: Deng
authors: Rong
authors: R
authors: Zhou
mesh_terms: D001120:Arginine / Q000627:therapeutic use*; D001724:Birth Weight / Q000187:drug effects; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy*; D007231:Infant, Newborn; D011225:Pre-Eclampsia / Q000517:prevention & control; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic
chemical_list: D001120:Arginine
keywords: L-arginine; hypertensive disorder of pregnancy; meta-analysis; randomized controlled trial; systematic review