Department of Medicine and Public Health, Nagoya Medical Science Research Institute, 1-118 Kamenoi, Meitou-ku, Nagoya, 465-0094, Japan.
Sci Rep. 2021 Nov 23;11(1):22748. doi: 10.1038/s41598-021-02182-6.
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.
不良出生结局与终生死亡率和发病率升高有关。本项随机对照试验的荟萃分析研究了产前口服 L-精氨酸是否对出生结局有影响。从最终符合条件的 10 篇文章中提取了总共 45 项总体质量良好的研究。与对照组相比，为有不良妊娠结局史的女性提供口服 L-精氨酸可显著降低宫内生长迟缓新生儿、早产和呼吸窘迫综合征的风险（分别为 n=7、3 和 3），并显著增加出生体重和胎龄（n=8 和 5）。与对照组相比，L-精氨酸可显著增加子痫前期高危或有子痫前期或妊娠期或轻度慢性高血压女性的 Apgar 评分（n=4）。与对照组相比，L-精氨酸对任何其他检查结果均无显著影响（n=2）。证据质量至少为中等或较高。因此，对于有不良妊娠结局史和子痫前期高危或有子痫前期或妊娠期或轻度慢性高血压的女性，口服 L-精氨酸至少可适度推荐。但是，由于研究效果较小，需要进一步的研究来提供更强的结论。
