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Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
Prenatal Amino Acid Supplementation to Improve Fetal Growth: A Systematic Review and Meta-Analysis
Fieke Terstappen1,2, Angela J C Tol3, Hendrik Gremmels4
1Department for Developmental Origins of Disease (DDOD), Wilhelmina Children's Hospital University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
Insights
Prenatal amino acid supplementation, particularly arginine, may improve fetal growth in complicated pregnancies. However, branched-chain amino acids and methyl donors showed no effect on fetal weight. Further research is needed.
Area of Science:
- Perinatal Medicine
- Nutritional Science
- Developmental Biology
Background:
- Aberrant fetal growth is a major contributor to perinatal complications and later-life non-communicable diseases.
- Prenatal nutrition plays a critical role in fetal development and long-term health outcomes.
- Amino acid supplementation is being investigated as a strategy to optimize fetal growth.
Purpose of the Study:
- To systematically review and meta-analyze human and animal studies on prenatal amino acid supplementation for promoting healthy fetal growth.
- To assess the impact of specific amino acid groups—arginine family, branched-chain amino acids (BCAAs), and methyl donors—on fetal/birth weight.
Main Methods:
- Systematic review and meta-analysis of studies from PubMed, Embase, and Cochrane libraries.
- Inclusion of studies involving oral supplementation of specific amino acid groups during gestation.
- Primary outcome measure was fetal/birth weight, with 22 human and 89 animal studies analyzed.
Main Results:
- Arginine family supplementation, specifically arginine and (N-Carbamyl)glutamate (NCG), showed beneficial effects on fetal/birth weight.
- Aspartic acid and citrulline did not demonstrate significant effects on fetal/birth weight.
- Branched-chain amino acids (BCAAs) and methyl donor supplementation did not influence fetal/birth weight. Effects of arginine were not observed with isonitrogenous control diets.
Conclusions:
- Arginine family supplementation, particularly arginine and NCG, shows promise for improving fetal growth in complicated pregnancies.
- BCAAs and methyl donors appear less effective for targeting fetal growth.
- Further well-controlled research in complicated pregnancies is necessary to confirm these findings and guide clinical recommendations.
Abstract:
Aberrant fetal growth remains a leading cause of perinatal morbidity and mortality and is associated with a risk of developing non-communicable diseases later in life. We performed a systematic review and meta-analysis combining human and animal studies to assess whether prenatal amino acid (AA) supplementation could be a promising approach to promote healthy fetal growth. PubMed, Embase and Cochrane libraries were searched to identify studies orally supplementing the following AA groups during gestation: (1) arginine family; (2) branched chain (BCAA); (3) methyl donors. Primary outcome was fetal/birth weight. 22 human and 89 animal studies were included in the systematic review. The arginine family, and especially arginine itself, was studied most. Our meta-analysis showed beneficial effects of arginine and (N-Carbamyl) glutamate (NCG), but not aspartic acid and citrulline on fetal/birth weight. However, no effects were reported when isonitrogenous control diet was included. BCAA and methyl donor supplementation did not affect fetal/birth weight. Arginine family supplementation, in particular arginine and NCG, improves fetal growth in complicated pregnancies. BCAA and methyl donor supplementation do not seem to be as promising to target fetal growth. Well controlled research in complicated pregnancies is needed before ruling out AA supplements or preferring arginine above other AAs.
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