The paediatrician and perinatologist Peter Dunn, who has died aged 91, introduced many innovations and developments that contributed to the dramatic improvements seen over the last half century in the survival, with no increased long-term impairment, of pre-term (and term) babies.
Largely due to his influence, newborn care emerged from its previous neglect to become a key specialty in paediatrics and child health; teamwork between obstetricians, midwives, neonatal paediatricians, nurses and others also benefited.
He played a significant part in combating over-intervention, emphasising the importance of the normal physiology and psychology of childbirth, including upright posture for delivery by most mothers and not cutting the umbilical cord until the vessels stop pulsating, with the delivered placenta positioned at the same level as the baby’s heart.
His contributions to perinatal classification systems were central, and he led the establishment of regional neonatal networks; the perinatal mortality in south-west England, where he was based at Bristol University, moved from being the highest for any region in 1980 to the lowest in 1983.
Peter coined the term perinatal medicine (in 1957) and pioneered the development of the specialty in the UK and internationally, through his organisational, clinical and research abilities and drive. The perinatal mortality rate – stillbirths and live-born infants dying in the first week – has fallen in England from 30 out of 1,000 births in 1965 to 6 in 1,000 in 2019.
He introduced neonatal intensive care in Bristol from 1968, when he was appointed senior lecturer in perinatal medicine and child health (the first such post in the world). Within three years neonatal mortality fell by 74%. In 1971, Bristol was the first unit in the UK to use continuous positive airway pressure to treat respiratory distress syndrome (RDS) of the newborn, a treatment subsequently extended into other specialties, including treatment for Covid-19.
I worked with Peter in Bristol for three years from 1981. We became good friends. He was a tall man, sometimes appearing formidable, but he was generous, witty and considerate. He helped prepare guidelines on many ethical aspects of human reproduction and women’s health. He also acted to preserve the right of parents and doctors to make compassionate decisions regarding the withholding of medical care, and supported colleagues subjected to professional medical injustice.
Peter’s research, largely observational, covered a wide range of perinatal problems, including the establishment of a sound screening programme for the detection of congenital dislocation of the hip, and demonstrating – then helping achieve World Health Organization recognition – that a range of congenital, postural deformities were due to prenatal intrauterine factors. He also undertook research on recognising and treating the blood disorder polycythaemia in newborns; and in developing a technique for umbilical cord management at pre-term Caesarean delivery, in order to prevent respiratory distress syndrome.
Peter was an assiduous record keeper, carefully documenting his clinical and research observations and his professional activities. The decade he spent gaining an exceptionally wide experience in newborn care as paediatric registrar and research fellow led him to new clinical approaches, which he audited and reported as proper management. It was a disappointment to him that many of his therapeutic developments failed to achieve widespread support.
Born in Birmingham, Peter was the fourth child, with three older sisters, of Naughton Dunn, a well-known orthopaedic surgeon, and Ethel (nee Jackson), an ex-Voluntary Aid Detachment nurse. He went to West House school, Birmingham, and Marlborough college, and from 1947 studied medicine at St John’s College, Cambridge, with his clinical training in Birmingham and Dublin. His national service (1955-57) was as a medical officer with the 2nd King Edward’s Own Gurkha Rifles during the Malayan emergency.
He was appointed research fellow and honorary registrar at Bristol in 1963 (his office was an old airing cupboard) and spent a year as a Fulbright scholar in San Francisco (1966-67). He was promoted to reader at Bristol in 1978, to a personal chair in 1987, then emeritus professor and senior research fellow in 1988, when he retired from clinical work but continued his academic and other activities.
Peter organised or co-organised 54 conferences, plenary sessions and workshops, and gave 767 invited lectures in 49 countries. Among other honours were the Gold Medal of the British Orthopaedic Association (1986) and the James Spence Medal from the RCPCH (2001). He served on many committees and working parties in the UK and internationally and advised governments and organisations such as the British Council and the WHO, including on how to improve appropriate perinatal care in developing countries.
In retirement he produced 80 leather-bound volumes in limited edition, which includes his professional correspondence, his research, his many publications and 150 reports on perinatal matters. He also wrote 108 scholarly essays on the subject of “Perinatal lessons from the past”.
Peter’s non-medical interests included archaeology and history (including the life of Sir Francis Bacon), photography, chess, golf, sailing, fly-fishing, countryside and hill walking. Earlier he had been a keen skier and squash, badminton and tennis player.
In 1961 Peter married Judy Lunt, a nurse from Great Ormond Street children’s hospital; he frequently acknowledged the great debt he owed Judy for her support. She survives him, along with their three children, Robert, John and Sara.
• Peter MacNaughton Dunn, paediatrician and perinatologist, born 23 June 1929; died 2 February 2021
