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Supplements of vitamins and minerals are often used by parents for children with Down’s syndrome in the hope that they will improve the children’s development. Now a trial in the Midlands, Greater London, and southwest England (BMJ 2008;336:594–7; see also editorial, ibid: 568–9) has provided no evidence that supplements of antioxidants, folinic acid, or both, are effective. A total of 156 infants with Down’s syndrome (mean corrected age 4.2 months) were randomised to daily supplementation with antioxidants (selenium, zinc, vitamin A, vitamin E, and vitamin C), folinic acid, both, or placebo. Eighteen months after the start of supplementation there were no significant differences between the groups in development assessed by the Griffiths developmental quotient and an adapted MacArthur communicative developmental inventory. Neither were there any differences in biochemical outcomes (red cell concentrations of copper/zinc superoxide dismutase and glutathione peroxidase and urinary concentrations of isoprostane). The use of such supplements is not recommended.

There is a widespread belief that around the world too many caesarean sections are performed. A major factor is first caesarean section and subsequent operative delivery because of the first. Now a study at eight hospitals in and around London (New England Journal of Medicine 2008;358:1346–53) has demonstrated that women pregnant for …

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