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Maternal Dietary L-Arginine and Adverse Birth Outcomes in Dar es Salaam, Tanzania.

Abstract
The amino acid arginine is a physiological precursor to nitric oxide, which is a key mediator of embryonic survival, fetal growth, and pregnancy maintenance. We evaluated the association between consumption of the amino acid arginine and the rate of adverse birth outcomes using data from a double-blind, randomized, placebo-controlled micronutrient supplementation trial among pregnant women in Dar es Salaam, Tanzania (2001-2004). Dietary intakes of arginine were assessed using repeated 24-hour recalls that were administered throughout pregnancy. Participants (n = 7,591) were monitored by research midwives throughout follow-up to assess pregnancy outcomes. Cubic-restricted splines and multivariable log-Poisson regression with empirical standard errors were used to estimate the continuous and categorical associations between arginine intake and adverse birth outcomes. Compared with women within the lowest quintile of arginine intake, those within the highest quintile had 0.79 times the risk of preterm birth before 37 weeks (95% confidence interval: 0.63, 1.00; P = 0.03). The continuous associations of arginine intake with preterm birth before 37 weeks and with preterm birth before 34 weeks were characterized by an initial rapid decrease in risk with increasing intake (P for nonlinearity < 0.01). Arginine intake was not associated with fetal loss or giving birth to infants who were born small for their gestational ages. This data suggest that the association between dietary arginine intake and preterm birth warrants further investigation.
AuthorsAnne Marie Darling, Chloe R McDonald, Willy S Urassa, Kevin C Kain, Ramadhani S Mwiru, Wafaie W Fawzi
JournalAmerican journal of epidemiology (Am J Epidemiol) Vol. 186 Issue 5 Pg. 603-611 (Sep 01 2017) ISSN: 1476-6256 [Electronic] United States
PMID28911008 (Publication Type: Journal Article)
Copyright© The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: [email protected].
Chemical References
  • Micronutrients
  • Arginine
Topics
  • Arginine (administration & dosage, physiology)
  • Diet
  • Dietary Supplements (statistics & numerical data)
  • Female
  • Humans
  • Infant, Newborn
  • Micronutrients (administration & dosage, physiology)
  • Poisson Distribution
  • Pregnancy
  • Pregnancy Outcome (epidemiology)
  • Premature Birth (epidemiology, prevention & control)
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Tanzania (epidemiology)

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