Revisión Sistemática: Suplementación con L-Arginina para la Prevención de la Restricción del Crecimiento Intrauterino
Bibliographic record
Abstract
This systematic review evaluated the effectiveness of L-arginine supplementation for the prevention and treatment of intrauterine growth restriction (IUGR) through evidence synthesis from clinical trials and observational studies. Concurrently, a systematic review was conducted following PRISMA 2020 guidelines. Systematic searches were performed in PubMed, Cochrane Library, Scopus, Web of Science, and LILACS up to October 2024, including randomized controlled trials and observational studies assessing L-arginine supplementation in pregnant women at risk of or diagnosed with IUGR. Methodological quality was assessed using the Jadad scale for clinical trials and the Newcastle-Ottawa scale for observational studies. Data were extracted on population characteristics, interventions, perinatal outcomes, and adverse events. A total of 427 records were identified through systematic search, with 15 studies ultimately included (11 randomized controlled trials and 4 observational studies) involving 1,842 participants. L-arginine supplementation showed a significant increase in birth weight, with a mean difference of 180 grams in high-quality studies. Doses ranged from 3 to 15 grams per day, with 3–6 grams being the most common. Improvements were observed in uteroplacental vascular resistance Doppler parameters and reductions in the incidence of neonatal respiratory distress syndrome. Reported adverse effects were minimal, mainly transient gastrointestinal discomfort. Heterogeneity among studies was moderate, related to differences in diagnostic criteria, dosages used, and timing of intervention onset. Overall, the available evidence suggests that L-arginine supplementation is a potentially beneficial intervention to improve neonatal outcomes in cases of intrauterine growth restriction, with a favorable safety profile. However, significant methodological limitations persist in existing studies, warranting further research through large-scale multicenter clinical trials to establish standardized dosage protocols, optimal initiation timing, and specific populations that may benefit most from this nutritional intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.028 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.009 |
| Bibliometrics | 0.009 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".