SynthesisFrontiers in pediatrics2026
Fetal and neonatal effects of N-acetylcysteine for maternal chorioamnionitis: a systematic review.
Synthesis in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Maternal chorioamnionitis (mCA) and intra-amniotic infection/inflammation (Triple I) are major causes of fetal inflammatory injury and are associated with preterm birth, white matter injury, cerebral palsy, bronchopulmonary dysplasia (BPD), and necrotising enterocolitis (NEC). No established therapy directly targets the inflammatory and oxidative pathways underlying fetal neuroinjury. N-acetylcysteine (NAC), a glutathione precursor with antioxidant and anti-inflammatory properties, has emerged as a potential adjunctive neuroprotective therapy, although human evidence remains limited. Objective: To evaluate fetal and neonatal outcomes associated with antenatal or intrapartum NAC administration in pregnancies complicated by mCA or Triple I. Methods: A systematic review was conducted using MEDLINE, Embase, Cochrane CENTRAL, and ClinicalTrials.gov from inception to December 23, 2025. Eligible studies included randomised controlled trials, prospective cohorts, non-randomised studies, and translational animal models evaluating NAC exposure in mCA or Triple I. Clinical outcomes, biomarkers, pharmacokinetics, and mechanistic pathways were synthesised narratively. Risk of bias was assessed using RoB 2, ROBINS-I, and SYRCLE tools. Results: Ten studies met the inclusion criteria, including five human and six translational animal studies. Human evidence involved approximately 143 mother-infant dyads. NAC exposure was associated with preserved cerebrovascular coupling, improved delivery-room adaptation, reduced severe neonatal morbidity, and lower BPD rates without major safety concerns. Pharmacokinetic studies demonstrated rapid placental transfer and gestation-dependent neonatal clearance. Animal studies consistently showed reductions in inflammatory cytokines, oxidative stress, apoptosis, and microstructural brain injury. Conclusion: NAC demonstrates biologically plausible neuroprotective potential in mCA and Triple I; however, the evidence remains preliminary due to small sample sizes and heterogeneous protocols. However, some studies showed no or negative effects. Large multicenter randomised trials with standardised dosing and long-term neurodevelopmental follow-up are needed before routine clinical implementation can be recommended.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.