The research lends new weight to those arguing that not all alcohol needs to be banned during pregnancy.

But midwives said today that the best advice remains for pregnant women to avoid alcohol.

The findings, published by BMJ Open, come from a study of nearly 7,000 children aged ten in the west of England.

Researchers sought to test brain development by tests of balance - concluding there was no evidence of problems linked to mothers having been drinkers during pregnancy.

However the researchers also found that women who drank during pregnancy tended to be wealthier than others - suggesting the possibility that any ill-effects might be masked by the benefits of an affluent lifestyle.

About 25% of the mothers drank up to seven glasses a week of alcohol.

The researchers at Bristol University, led by Professor John Macleod, say: "In general, better static balance was associated with greater levels of affluence and educational attainment.

"And in this group of mums, moderate alcohol intake was a marker for social advantage, which may itself be the key factor in better balance, possibly overriding subtle harmful effects of moderate alcohol use."

Janet Fyle, of the Royal College of Midwives, said: “We recognise that this is useful research. However, there is also a large amount of evidence suggesting that the cumulative effects of alcohol consumption during pregnancy can harm the developing foetus.

"Our advice continues to be that for women who are trying to conceive or those that are pregnant it is best to avoid alcohol."

BMJ Open 18 June 2013 [abstract]

Research from the Netherlands, which has the highest home birth rate among Western countries, looked to see if low risk women at the onset of labour with planned home birth had a higher rate of rare but severe outcomes or complications such as haemorrhage, than those with planned hospital births.

The findings, reported in the British Medical Journal, show that between one and two in every thousand Dutch women having a home birth suffered severe complications.

But between 2% and 4% of women giving birth at home suffered haemorrhage.

The findings were welcomed by British midwives - although they stressed that only some women can be advised it is safe to give birth at home.

Cathy Warwick, chief executive of the Royal College of Midwives, said: “This is further evidence of the safety and benefits of home birth for appropriately selected women, particularly women who given birth before.

"Providing choice of place of birth is at the heart of the Government’s agenda so it was disappointing that last year saw a drop in home births. We should be aiming to see home births at the levels of the 1960s when a third of women had their babies in their homes.”

Using data from a national study into maternal morbidity and national birth registry data from August 2004 to August 2006, the Dutch researchers, led by Professor Jos van Roosmalen, a perinatologist at the Leiden University Medical Centre, identified 146,752 low risk women in primary care at the onset of labour.

Of those, 92,333 (63%) had a planned home birth and 54,419 (37%) a planned hospital birth.

For women having their first baby, the rate of severe outcomes for a planned home birth was 2.3 per 1,000 compared with 3.1 per 1,000 for a planned hospital birth. The rate of postpartum haemorrhage was 43.1 per 1,000 for a planned home birth compared with 43.3 per 1,000 for a planned hospital birth.

It found among women who had previously given birth, the rate of severe outcomes for a planned home birth was 1 per 1,000 compared with 2.3 per 1,000 for a planned hospital birth. The rate of postpartum haemorrhage was 19.6 per 1,000 for a planned home birth compared with 37.6 per 1,000 for a planned hospital birth.

Although they emphasise that their findings may only apply to regions where midwives are well trained to assist women at home births and where facilities for transfer of care and transportation in case of emergencies are adequate, they say the fact that they did not find higher rates of severe complications among planned home births “should not lead to complacency” and that “every avoidable adverse maternal outcome is one too many”.

“Low risk women in primary care with planned home birth at the onset of labour had a lower rate of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned hospital birth,” they say. “These differences were statistically significant for parous women.”

De Jong A et al. Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study. BMJ. BMJ 2013;346:f3263 doi: 10.1136/bmj.f3263 [abstract]

A new study suggests the technique could prevent as many as 600 cases of the disease annually.

Researchers have been analysing the benefits of testing for the human papillomavirus, which lies behind most cases of cervical cancer.

Teenage girls are already being offered a programme of vaccination against infection with the virus.

The new study suggests the first test women under should look for this virus.

The research, conducted at Queen Mary, University of London, UK, was being reported to the conference of the National Cancer Intelligence Network in Brighton, UK.

The researchers looked at the recorded of some 8,750 women diagnosed with cervical cancer and found that as many as 40% had been cleared by a smear test in the six years before diagnosis.

They say that 95% of these women would have been identified through virus testing.

Researcher Professor Peter Sasieni said: “Cervical cancer screening is already hugely effective but our study shows how much better it could be by swapping to primary HPV testing.

"Not only would introducing primary HPV testing prevent more cases of cancer, it would also mean women who tested negative wouldn’t need to be checked as often.”

Hazel Nunn, of Cancer Research UK, which backed the research, said the idea was already being piloted in parts of England.

She said: "Although we already have a very effective cervical cancer screening programme, this study suggests that we could do even better if primary HPV testing was introduced here in the UK."

Castanon A et al. How much could primary human papillomavirus testing reduce cervical cancer incidence and morbidity? Journal of Medical Screening 14 June 2013

Rates of premature birth and caesarean section are both closely linked to the mother's age, according to the new study.

The results could help obstetricians in developing care plans for mothers of different ages.

Professor Deirdre Murphy of Dublin University, Ireland, and her team gathered figures from 36,916 first-time mothers over 12 years. For this study they focused on those women at the extremes of maternal age, 17 or younger and 40 or older, and compared them against a comparison group aged 20 to 34 years.

Mothers in the over 40 group were the most likely to need a caesarean, having three times the rate of the comparison group. Their babies were more likely to need to stay in hospital during their first few days of life (24% versus 17% in the comparison group).

At the other end of the age range, mothers aged 17 and below had a higher risk of preterm birth (10% versus 6% for the comparison group). Full details are published today (12 June) in BJOG: An International Journal of Obstetrics and Gynaecology.

Professor Murphy said: "There was a marked difference in the rate of caesarean sections, increasing with maternal age, and more research is needed to explore the care provided to younger mothers and whether their enhanced ability to deliver naturally may suggest a reduction is possible for overall caesarean section rates."

She added: "Maternal age is an important risk factor to be considered when planning care for first-time mothers, particularly those at the extremes of maternal age."

Journal deputy editor, John Thorp, added that the findings "suggest other socio-demographic factors, associated with age, play an important role in delivery outcomes". Therefore, he states that obstetricians must plan care for pregnant women accordingly.

Denis, A. et al. Delivery outcomes for nulliparous women at the extremes of maternal age - a cohort study. BJOG: An International Journal of Obstetrics and Gynaecology 12 June 2013 doi: 10.1111/1471-0528.12311

Work carried out at the Academy of Finland’s Centre of Excellence in Cancer Genetics Research, based at the University of Helsinki, has shown how the genome of fibroids, known as benign uterine leiomyomata, differs from normal uterine tissue.

Professor Lauri Aaltonen, who heads the centre, said very little was known about the mechanisms behind the development of the problem but the work carried out by the researchers has identified a gene defect that explains how more than half the tumours developed.

Its latest whole-genome sequencing demonstrated that most of the other tumours develop as a result of chromosome fragmentation and rearrangements.

Such changes resulting from chromosomal rearrangements are normally identified in malignant tumours but these results suggest that the same mechanisms may also cause non-cancerous tumours.

“These new findings are essential for the further development of pharmacological treatments for this type of tumour,” says Prof Aaltonen, whose work is published in the latest edition of the New England Journal of Medicine.

“Our research also indicates what mechanisms may prevent benign tumours from becoming malignant,” Aaltonen adds.

Aaltonen L et al. Characterization of Uterine Leiomyomas by Whole-Genome Sequencing. New England Journal of Medicine. 5 June 2013. DOI: 10.1056/NEJMoa1302736

Dramatic pictures, obtained from so-called 4D imaging, show the development of facial expressions.

Researchers say they do not know if the expressions represent real pain - or whether they represent the face developing the ability to show expressions.

The work at Durham University, UK, involved taking scans of 15 healthy babies between 24 and 36 weeks of pregnancy.

The researchers, reporting in the journal PLoS One, say that at 24 weeks babies were showed simple "one dimensional" expressions such as a smile.

By 36 weeks they were capable of screwing their faces up into an expression of pain.

Researcher Dr Nadja Reissland said: "It is vital for infants to be able to show pain as soon as they are born so that they can communicate any distress or pain they might feel to their carers and our results show that healthy foetuses 'learn' to combine the necessary facial movements before they are born.

"This suggests that we can determine the normal development of facial movements and potentially identify abnormal development too. This could then provide a further medical indication of the health of the unborn baby."

Reissland N, Francis B, Mason J. Can Healthy Fetuses Show Facial Expressions of Pain or Distress PLoS ONE 6 June 2013; 8(6): e65530. doi:10.1371/journal.pone.0065530

The findings come from a laboratory study conducted in Edinburgh, UK.

Researchers said an obese mother might transmit health problems not to her children but to her grandchildren - putting them at increased risk of diseases such as diabetes and heart disease.

However the theory, reported in the journal Endocrinology, has so far been only tested on laboratory mice.

Researcher Dr Amanda Drake said: "Given the worldwide increase in obesity, it is vital that we gain an understanding of how future generations may be affected.

"Future studies could look at these trends in humans but they would need to take into account genetics, environmental, social and cultural factors."

The British Heart Foundation said the findings would have "major" public health implications if they proved true in humans.

June Davison, of the foundation, said: "Obesity rates are at an all-time high so it’s vitally important we gain an understanding of how future generations may be affected.

"This research suggests the consequences of obesity may affect the health of a mother’s grandchildren but the mechanisms behind how those effects are transmitted remain unknown."

Vicky King et al. Maternal obesity has little effect on the immediate offspring but impacts on the next generation. Endocrinology June 2013.

Dr Michelle Bellingham of Glasgow University, UK, and colleagues make their comments in a Scientific Impact Paper - Chemical exposures during pregnancy - launched by the Royal College of Obstetricians and Gynaecologists.

It may be beneficial for pregnant and breastfeeding women to limit exposure to certain chemicals, but currently there is no official antenatal advice on the subject.

Links have been found between high levels of some environmental chemicals and preterm birth, low birthweight, congenital defects, pregnancy loss, impaired immune development and impaired fertility. While the links have yet to be proven scientifically, potential sources of harm include herbal remedies, medicines, household cleaning products and cosmetics.

The authors point out that current laws do not require manufacturers to list all potentially harmful chemicals on packaging. They suggest avoiding paint fumes and pesticides, and only taking medicines when necessary.

"While there is no official advice on this topic available to pregnant women, there is much conflicting anecdotal evidence about environmental chemicals and their potentially adverse effects on developing babies," said Dr Bellingham.

Co-author Professor Richard Sharpe added: "For most environmental chemicals we do not know whether or not they really affect a baby's development, and obtaining definitive guidance will take many years."

"Women with concerns about certain chemical exposures should consult their obstetrician or midwife," advised Professor Scott Nelson of the Royal College of Obstetricians and Gynaecologists.

Midwives meanwhile said women should not be "unnecessarily alarmed" by the findings.

Janet Fyle, of the Royal College of Midwives, said: ”It is common sense advice, such as using fresh food rather than processed foods.

"However, pregnant women must take this advice with caution and use their common sense and judgement and not be unnecessarily alarmed about using personal care products, such as moisturisers, cosmetics and shower gels."

She added: "There needs to be more scientific and evidence-based research into the issues and concerns raised by this paper."

As many as 15% of babies born in Britain are now delivered through emergency caesarean procedures - and women will often need a general anaesthetic, the European Society of Anaesthesiology, meeting in Barcelona, Spain, heard.

Another 10% of births take place through planned procedures. The World Health Organisation says the national rate of Caesarean section should be just 15%.

Doctors said there were a range of reasons for this including the increased age at which women give birth and growing rates of obesity.

Pressure from some women to have planned operations might also put them at risk of needing emergency procedures when they had further babies.

Dr Geraldine O'Sullivan of Guy's and St Thomas' NHS Foundation Trust, London, UK, told the conference: "The increased Caesarean section rate is putting anaesthesia, obstetric, and midwife teams under much greater strain at a time when there are increasingly reduced resources across healthcare systems in Europe."

Dr Tony Falconer, president of the Royal College of Obstetricians and Gynaecologists, said: "We are seeing a more complicated case load with the rising levels of obesity, multiple births and older mothers. 

"These complex deliveries require the presence of senior medical staff and support the case for more consultants on labour wards.  This may impact on lowering the c-section rate and will improve safety for mother and baby."

Midwife leaders said there was still scope to discourage women from seeking to give birth by Caesarean section.

Louise Silverton, of the Royal College of Midwives, said: “We would encourage women to talk about their birth with their midwife or doctor so that they are fully aware of the implications of decisions they may make not just about having a caesarean section, but these other aspects of birth also.

"We need to ensure that women have more time with midwives in the antenatal period to discuss these issues."

A new study has shown that women under the age of 40 respond very differently to older women to standard treatments.

Researchers said the findings may help explain why survival rates are poor among young women who contract the disease.

They now say it may be necessary to continue the drug tamoxifen for longer than the standard five years for these women.

Studies of tamoxifen have suggested that after five years of treatment women suffer low relapse rates.

But the latest study involving some 3,000 women at 127 British hospitals found high rates of relapse among women under the age of 40.

The findings have been reported in the Journal of the National Cancer Institute.

Researcher Professor Dianna Eccles, head of Cancer Research UK’s Southampton Clinical Trials Unit, said: “This study adds to the evidence that breast cancer can behave very differently when diagnosed in younger women. They may require a different approach to treatment – which isn’t necessarily understood from cancer trials in older patients.

“Research is the key to improving survival for these women and we urgently need trials to help us develop new treatments tailored specifically at this age group.”

* A second study published yesterday backed long-term treatment with tamoxifen. Researchers said ten years of treatment with the drug halved the risk of dying compared with five years of treatment - when women have the common oestrogen receptor positive form of cancer.

British researchers were reporting their findings at a conference of the American Society of Clinical Oncology.

They show a reduction in death rates of about 7%, equivalent to 60 deaths among the 3,500 women taking the drug for ten years.

The findings come from a study of nearly 7,000 women.

Researcher Dr Daniel Rea, of Birmingham University, UK, said: “These results are important as they establish that giving tamoxifen for longer than the current standard of five years significantly cuts the risk of breast cancer returning.

“Doctors are now likely to recommend continuing tamoxifen for an extra five years and this will result in many fewer breast cancer recurrences and breast cancer deaths worldwide."

Copson E.R. et al, Breast cancer diagnosis and treatment in women aged 18-40 years in the UK: the POSH study Journal of the National Cancer Institute 31 May 2013

aTTom: Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer. [abstract]