Peter Dunn pioneered a new specialty, for which he coined the term ‘perinatal medicine’. He became professor of perinatal medicine and child health at the University of Bristol, founded the British Association of Perinatal Medicine (BAPM) in 1976, and contributed to improving outcomes for newborn babies around the world.
He was born in Birmingham, the fourth child with three older sisters. His father, Naughton Dunn, was an eminent orthopaedic surgeon; his mother, Ethel Dunn (née Jackson), had been a nurse. His education was at West House School, Birmingham, Marlborough College, St John´s College, Cambridge (from 1947 to 1950), and then in Birmingham and Dublin (from 1950 to 1953).
Following pre-registration jobs in Birmingham, he undertook National Service as a captain in the Royal Army Medical Corps, serving from 1955 to 1957 in the 2nd King Edward VII’s Own Gurkha Rifles during the Malayan Emergency.
After returning to the UK, he gained experience in obstetrics, paediatrics and general practice in Birmingham. This was the time when he became fascinated by the continuity of fetal existence and life for the infant after delivery. The care of a child after birth needed to be combined with care of the fetus in utero. During the following decade, from 1959 to 1968, he held paediatric registrar posts in Birmingham, south Warwickshire and Bristol, and research posts in Bristol and at the Cardiovascular Research Institute, University of California at San Francisco. In 1968, he obtained a Cambridge MD for a thesis on congenital postural deformation, particularly congenital dislocation of the hip.
In 1968, he was appointed as a consultant senior lecturer in perinatal medicine and child health at the University of Bristol, the first such post in the UK. He introduced neonatal intensive care to Bristol in 1970 and neonatal mortality fell by 74% in three years. In 1979, he was promoted to reader and, in 1987, he was awarded a personal chair in perinatal medicine and child health.
Peter Dunn´s research activities were extensive and had practical clinical relevance. In 1971, he introduced continuous positive airway pressure to neonatal intensive care for the first time in the UK. He published a guide to the depth of insertion of an umbilical artery catheter, vital for monitoring blood gases in respiratory distress syndrome.
He was ahead of his time in questioning the wisdom of immediate clamping of the umbilical cord at birth. He considered that it was more physiological to wait for the circulation to adapt, allowing blood to be transfused from placenta to the neonate and improving blood flow to the lungs. He was also one of the very first to recognise that neonatal polycythaemia impaired tissue perfusion and increased jaundice. Liver injury in haemolytic disease, neonatal intestinal obstruction, multiple pregnancy, diabetic pregnancy, testicular birth trauma, necrotising enterocolitis and breech presentation were just some of his publication areas.
Two very important objectives for Dunn were promoting better organisation of perinatal care and comprehensive record keeping and data collection on all newborn infants. Peter saw accurate data as essential for planning, improving and monitoring obstetric and neonatal care.
In 1976, Dunn founded the British Association of Perinatal Medicine with the 20 paediatricians working in major neonatal units around the UK and the Republic of Ireland. He became its first president and, indeed, filled all its offices during its early years. The aims of BAPM were (and are) to improve the standard of perinatal care and to bring together those involved as a team – obstetricians, midwives, paediaticians and neonatal nurses.
One of the first tasks of BAPM was to ascertain the resources available for newborn care and to determine what was required to provide a safe service. Dunn chaired a joint committee of the Royal College of Obstetricians and Gynaecologists and the British Paediatric Association, and produced a report Recommendations for the improvement of infant care during the perinatal period in the UK (London, British Paediatric Association/Royal College of Obstetricians and Gynaecologists, 1978). This was warmly welcomed and forwarded to House of Commons’ social services committee, chaired by Renée Short, and led to the formal recognition of perinatal medicine in the UK.
Between 1970 and 2000, Peter Dunn was very active at modernising paediatric and perinatal diagnostic definitions in the UK and for the World Health Organization. He played a major role in preparing the congenital anomalies and paediatric sections of the 9th (1977) and 10th (1992) revisions of the International Classification of Diseases.
Between 1976 and 2000, he was a member of four committees of the International Federation of Gynecologists and Obstetricians, covering standardisation of terms, perinatal mortality and morbidity, epidemiology and ethics in human reproduction. Peter Dunn was a founder member of the European Association of Perinatal Medicine and made significant contributions to its scientific committee between 1972 and 1996.
In the 1990s, he worked hard to promote the creation of a Royal College of Paediatrics and Child Health, which was finally achieved in 1996. He was made an honorary fellow.
As a practising clinician with insight into inequality of resources, he was very aware of how a clinician may not be able to function optimally because of a difficult administrative or financial environment. He acted as an expert witness defending the obstetrician Wendy Savage against a charge of incompetence in 1985 and, from 1995 to 2000, defended the Bristol paediatric heart surgeons following concerns about high mortality rates.
During retirement, he indulged his passion for archiving, writing and founding new societies, including the British Society for the History of Paediatrics and Child Health. He published 108 scholarly articles on individuals who have made significant contributions to the development perinatal medicine over 2000 years. All were published in the Archives of Disease in Childhood under the title ‘Perinatal lessons from the past’.
In 2001, the Royal College of Paediatrics and Child Health awarded Dunn the James Spence medal for distinguished contributions to paediatrics, their highest award.
His non-medical interests included squash, badminton, tennis and skiing, then golf, fly fishing, sailing, chess, archaeology and history. In 1961, he married Judy (née Lunt), a nurse at Great Ormond Street Hospital, and they had three children, Robert, John and Sara. He owed a great debt to his wife for her support and they were frequently generous hosts to colleagues from near and far at their Bristol home.
A Whitelaw
[British Association of Perinatal Medicine Professor Peter Dunn Obituary 8 Feb 2021 www.bapm.org/articles/274-professor-peter-dunn-obituary – accessed 27 March 2021; The Telegraph 21 February 2021 www.telegraph.co.uk/obituaries/2021/02/21/professor-peter-dunn-paediatrician-improved-care-newborn-babies/ – accessed 27 March 2021; The Guardian 17 March 2021 www.theguardian.com/science/2021/mar/17/peter-dunn-obituary – accessed 27 March 2021]