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

J Hum Hypertens. 2014 Apr;28(4):230-5. doi: 10.1038/jhh.2013.100. Epub 2013 Oct 31.


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.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Arginine / physiology
  • Arginine / therapeutic use*
  • Blood Pressure / physiology
  • Female
  • Humans
  • Middle Aged
  • Pre-Eclampsia / drug therapy*
  • Pre-Eclampsia / physiopathology
  • Pre-Eclampsia / prevention & control*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy*
  • Pregnancy Complications, Cardiovascular / physiopathology
  • Pregnancy Complications, Cardiovascular / prevention & control*
  • Pregnancy Outcome
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Treatment Outcome
  • Vasodilation / physiology
  • Young Adult


  • Arginine