An editorial notes that these findings are another disappointment in the long search for a more effective measure to prevent pre-eclampsia. Other treatments, such as antioxidant supplements, have been equally biologically plausible but failed to translate into clinical benefits. This may reflect the heterogeneity of the syndrome and the concept of a one size fits all prophylactic against pre-eclampsia is as unlikely; even aspirin has different effects on pre-eclampsia risk in different subgroups. It suggests that pending further research, a global reduction in pre-eclampsia related deaths will require implementation of the evidence base that already exists for aspirin prophylaxis, prompt recognition and treatment of hypertension, use of magnesium sulfate (for prevention of eclamptic seizures), and timely delivery. It adds that recommendation of low dose folic acid supplementation before pregnancy and in the first trimester must continue for prevention of neural tube defects.