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The role of L-arginine in the prevention and treatment of pre-eclampsia: a systematic review of randomised trials

Journal of Human Hypertension volume 28, pages 230–235 (2014)Cite this article

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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.

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Authors and Affiliations

  1. The University of Adelaide, Robinson Institute and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia, Australia

    T Dorniak-Wall, R M Grivell, G A Dekker, W Hague & J M Dodd

  2. Department of Perinatal Medicine, The Women’s and Children’s Hospital, North Adelaide, South Australia, Australia

    R M Grivell, W Hague & J M Dodd

  3. Department of Obstetrics & Gynaecology, The Lyell McEwin Hospital, Elizabeth, South Australia, Australia

    G A Dekker

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Correspondence to R M Grivell.

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Dorniak-Wall, T., Grivell, R., Dekker, G. et al. The role of L-arginine in the prevention and treatment of pre-eclampsia: a systematic review of randomised trials. J Hum Hypertens 28, 230–235 (2014). https://doi.org/10.1038/jhh.2013.100

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