Document Type : Systematic Review

Authors

1 MD, Department of Obstetrics and Gynecology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 MD, Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Tehran, Iran.

3 MD, Internist, Assistant Professor, Department of Internal Medicine, School of Medicine, Firoozabadi Clinical Research Development Unit (FACRDU), Iran University of Medical Sciences, Tehran, Iran

4 MD, Department of Obstetrics and Gynecology, School of Medicine, Firoozabadi Clinical Research Development Unit (FACRDU), Iran University of Medical Sciences, Tehran, Iran.

5 MD, Firoozabadi Clinical Research Development Unit (FACRDU), Iran University of Medical Sciences, Tehran, Iran.

6 MD, Department of Obstetrics and Gynecology, Yasuj University of Medical Sciences, Yasuj, Iran

10.22074/ijfs.2024.2016433.1580

Abstract

Preeclampsia (PE) remains a significant cause of maternal and neonatal morbidity and mortality, particularly in high-risk pregnancies. The present study aims to assess the efficacy of L-arginine supplementation in preventing PE and improving maternal and neonatal outcomes in high-risk pregnancies. We searched international databases (Web of Science, PubMed, Scopus, and Embase) and extracted studies evaluating the efficacy of L-arginine for preventing PE and improving maternal and neonatal outcomes in high-risk pregnancies. The data collected underwent analysis utilizing the random-effects model in STATA (version 15). Out of the collected studies, ten met the eligibility criteria, comprising a total sample size of 1165 subjects (586 cases and 584 controls). The mean age of the cases was 28 ± 5.05 years, while that of the controls was 27.32 ± 4.58 years. The results revealed that L-arginine was more effective in reducing the incidence of PE than placebo [odds ratio (OR)=0.36; 95% confidence interval (CI) 0.17, 0.77]. Also, the results showed that there is no statistically significant difference between the two groups in the systolic and diastolic blood pressure (SMD -0.35; 95% CI -91, 21), and (SMD -0.50; 95% CI -1.08, 0.07), respectively. In the neonatal weight at birth, a statistically significant difference was observed between the two groups (SMD -0.16; 95% CI -31, -0.01). Also, there was no statistically significant difference between the two groups in gestational age (SMD 0.6; 95% CI -0.06, 0.18). Furthermore, there was no significant difference between the two groups in the APGAR score at 1 minute (SMD 0.40; 95% CI -0.02, 0.82). Our findings revealed that the L-arginine Supplement during pregnancy reduced the incidence of PE in high-risk pregnancies. However, it does not significantly improve maternal and neonatal outcomes.

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