Nitric oxide for preventing pre-eclampsia and its complications
Abstract
Background: Pre-eclampsia, a multisystem disorder of pregnancy characterised by high blood pressure and protein in the urine, is associated with endothelial dysfunction. Nitric oxide mediates many functions of the endothelium, including vasodilatation and inhibition of platelet aggregation. Pre-eclampsia may be associated with nitric oxide deficiency, but the evidence to support this suggestion is contradictory. Nevertheless, it has been hypothesised that agents which increase nitric oxide may prevent pre-eclampsia.
Objectives: To assess the effectiveness and safety of nitric oxide donors and precursors for preventing pre-eclampsia and its complications.
Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2006), CENTRAL (The Cochrane Library 2006, Issue 3), and EMBASE (2002 to December 2004).
Selection criteria: Studies were included if they were randomised trials evaluating nitric oxide donors or precursors for preventing pre-eclampsia and its complications.
Data collection and analysis: Both review authors independently assessed studies for inclusion. Data were extracted and double checked for accuracy.
Main results: Six trials (310 women) were included. Four were of good quality and two were of uncertain quality. Four trials (170 women) compared nitric oxide donors (glyceryl trinitrate) or precursors (L-arginine) with either placebo or no intervention. There are insufficient data for reliable conclusions about the effects…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 310 participants or records.
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