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Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis

BACKGROUND: Intrauterine growth restriction (IUGR) is associated with perinatal morbidity and mortality. Several clinical trials have reported L-arginine and sildenafil citrate had effect on intrauterine growth restriction fetuses. A meta-analysis of available randomized controlled trials (RCTs) was...

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Autores principales: Chen, Juncao, Gong, Xiaoyuan, Chen, Pingyang, Luo, Kaiju, Zhang, Xiuquan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4986189/
https://www.ncbi.nlm.nih.gov/pubmed/27528012
http://dx.doi.org/10.1186/s12884-016-1009-6
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author Chen, Juncao
Gong, Xiaoyuan
Chen, Pingyang
Luo, Kaiju
Zhang, Xiuquan
author_facet Chen, Juncao
Gong, Xiaoyuan
Chen, Pingyang
Luo, Kaiju
Zhang, Xiuquan
author_sort Chen, Juncao
collection PubMed
description BACKGROUND: Intrauterine growth restriction (IUGR) is associated with perinatal morbidity and mortality. Several clinical trials have reported L-arginine and sildenafil citrate had effect on intrauterine growth restriction fetuses. A meta-analysis of available randomized controlled trials (RCTs) was conducted to investigate the effects of L-arginine and sildenafil citrate on major clinical outcomes of IUGR fetuses. METHODS: Systematically searched Medline, Embase, the Cochrane Library, and Clinical Trials, references of retrieved articles, and conference proceedings from 1960 to 2015. We included randomized controlled trials assessing the effects of L-arginine and sildenafil citrate on IUGR. Outcomes analyzed were the birth weight, gestational age at labor, Apgar score at 1and 5 min, the ratio of NRDS, the ratio of ICH and neonatal death, etc. RESULTS: Ten trials were included. Nine trials (576 patients) compared L-arginine with either placebo or no intervention. In the L-arginine treatment groups of the L-arginine trials, there was a significant increase in fetal birth weight (SMD 0.41, 95 % CI [0.24,0.58]), gestational age (SMD 0.30, 95 % CI [0.07,0.54]); L-arginine treatment group have a significant reduction in the ratio of neonatal respiratory distress syndrome (P = 0.009), intracranial hemorrhage of fetuses (P = 0.002), but the number of included studies and people on these outcomes are small. As only one trial (41 patients) compared sildenafil citrate with placebo, it was too small for reliable conclusions about possible differential effects could be drawn. CONCLUSIONS: The results of this meta-analysis showed that L-arginine increased birth weight and prolonged gestational age at labor of IUGR fetuses. However, further large-scale RCTs are needed to adequately assess the effect of L-arginine and Sildenafil citrate on clinical outcomes, because the number of study may be small. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-016-1009-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-49861892016-08-17 Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis Chen, Juncao Gong, Xiaoyuan Chen, Pingyang Luo, Kaiju Zhang, Xiuquan BMC Pregnancy Childbirth Research Article BACKGROUND: Intrauterine growth restriction (IUGR) is associated with perinatal morbidity and mortality. Several clinical trials have reported L-arginine and sildenafil citrate had effect on intrauterine growth restriction fetuses. A meta-analysis of available randomized controlled trials (RCTs) was conducted to investigate the effects of L-arginine and sildenafil citrate on major clinical outcomes of IUGR fetuses. METHODS: Systematically searched Medline, Embase, the Cochrane Library, and Clinical Trials, references of retrieved articles, and conference proceedings from 1960 to 2015. We included randomized controlled trials assessing the effects of L-arginine and sildenafil citrate on IUGR. Outcomes analyzed were the birth weight, gestational age at labor, Apgar score at 1and 5 min, the ratio of NRDS, the ratio of ICH and neonatal death, etc. RESULTS: Ten trials were included. Nine trials (576 patients) compared L-arginine with either placebo or no intervention. In the L-arginine treatment groups of the L-arginine trials, there was a significant increase in fetal birth weight (SMD 0.41, 95 % CI [0.24,0.58]), gestational age (SMD 0.30, 95 % CI [0.07,0.54]); L-arginine treatment group have a significant reduction in the ratio of neonatal respiratory distress syndrome (P = 0.009), intracranial hemorrhage of fetuses (P = 0.002), but the number of included studies and people on these outcomes are small. As only one trial (41 patients) compared sildenafil citrate with placebo, it was too small for reliable conclusions about possible differential effects could be drawn. CONCLUSIONS: The results of this meta-analysis showed that L-arginine increased birth weight and prolonged gestational age at labor of IUGR fetuses. However, further large-scale RCTs are needed to adequately assess the effect of L-arginine and Sildenafil citrate on clinical outcomes, because the number of study may be small. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-016-1009-6) contains supplementary material, which is available to authorized users. BioMed Central 2016-08-16 /pmc/articles/PMC4986189/ /pubmed/27528012 http://dx.doi.org/10.1186/s12884-016-1009-6 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Chen, Juncao
Gong, Xiaoyuan
Chen, Pingyang
Luo, Kaiju
Zhang, Xiuquan
Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis
title Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis
title_full Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis
title_fullStr Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis
title_full_unstemmed Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis
title_short Effect of L-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis
title_sort effect of l-arginine and sildenafil citrate on intrauterine growth restriction fetuses: a meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4986189/
https://www.ncbi.nlm.nih.gov/pubmed/27528012
http://dx.doi.org/10.1186/s12884-016-1009-6
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