title: The role of L-arginine in the prevention and treatment of pre-eclampsia: a systematic review of randomised trials.
abstract: Pre-eclampsia is a significant health issue in pregnancy, complicating between 2-8% of pregnancies. L-arginine is an important mediator of vasodilation with a potential preventative role in pregnancy related hypertensive diseases. We aimed to systematically review randomised trials in the literature assessing the role of L-arginine in prevention and treatment of pre-eclampsia. We searched the Cochrane Controlled Trials Register, PUBMED, and the Australian and International Clinical Trials Registry, to identify randomised trials involving pregnant women where L-arginine was administered for pre-eclampsia to improve maternal and infant health outcomes. We identified eight randomised trials, seven of which were included. The methodological quality was fair, with a combined sample size of 884 women. For women at risk of pre-eclampsia, L-arginine was associated with a reduction in pre-eclampsia (RR: 0.34, 95% CI: 0.21-0.55), when compared with placebo and a reduction in risk of preterm birth (RR: 0.48 and 95% CI: 0.28 to 0.81). For women with established hypertensive disease, L-arginine was associated with a reduction in pre-eclampsia (RR: 0.21; 95% CI: 0.05-0.98). L-arginine may have a role in the prevention and/or treatment of pre-eclampsia. Further well-designed and adequately powered trials are warranted, both in women at risk of pre-eclampsia and in women with established disease.
authors.affiliation: The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Dorniak-Wall
authors.affiliation: 1] The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia [2] The Women's and Children's Hospital, Department of Perinatal Medicine, North Adelaide, South Australia, Australia.
authors.forename: R M
authors.initials: RM
authors.lastname: Grivell
authors.affiliation: 1] The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia [2] The Lyell McEwin Hospital, Department of Obstetrics & Gynaecology, Elizabeth, South Australia, Australia.
authors.forename: G A
authors.initials: GA
authors.lastname: Dekker
authors.affiliation: 1] The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia [2] The Women's and Children's Hospital, Department of Perinatal Medicine, North Adelaide, South Australia, Australia.
authors.forename: W
authors.initials: W
authors.lastname: Hague
authors.affiliation: 1] The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia [2] The Women's and Children's Hospital, Department of Perinatal Medicine, North Adelaide, South Australia, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Dodd
mesh_terms: D000293:Adolescent; D000328:Adult; D001120:Arginine / Q000502:physiology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome; D014664:Vasodilation / Q000502:physiology; D055815:Young Adult
chemical_list: D001120:Arginine