Liggins Institute
Dr Chris McKinlay
Current position
Senior Lecturer, Liggins Institute, the University of Auckland
Liggins Institute postgraduate programme
PhD, awarded 2012
Research topic
Early School Age Outcomes after Exposure to Repeat Antenatal Glucocorticoids
Supervisors
Distinguished Professor Jane Harding
Professor Wayne Cutfield
Dr Chris McKinlay already held an MBChB and Diploma of Professional Ethics when he interrupted specialty training in neonatology to embark on a PhD at the Liggins Institute. He says he was keen to spend more time working with Jane Harding, whom he had known while working as a junior doctor at National Women’s Hospital.
“Jane is a great teacher and very enthusiastic about perinatal research,” he says. “At the Liggins I had the opportunity to conduct important research relevant to my clinical field, with excellent mentoring from academic and laboratory supervisors. Research group and departmental meetings were always stimulating with regular visits from international speakers.”
His research investigated the long-term effect of antenatal glucocorticoid exposure on childhood risk factors for cardiovascular and metabolic disease. It expanded on the seminal work of Professor Sir Graham Liggins and Associate Professor Ross Howie, who first showed in the 1970s that antenatal glucocorticoid therapy dramatically improves the survival and health of preterm babies.
Read about Sir Graham (Mont) Liggins
More recent clinical trials have demonstrated that giving repeat doses to women at risk of preterm birth has additional benefits for their infants. However there has been concern that increased fetal exposure to glucocorticoids may increase the risk of chronic disease in later life, particularly diabetes and cardiovascular illness.
The study followed up school-age children who had previously been part of a randomised controlled trial conducted throughout Australia and New Zealand. Assessments included body composition, using DXA scanning, ambulatory blood pressure monitoring, measurement of glucose and insulin metabolism, and profiles of salivary and plasma cortisol. Children were seen in the Paykel Clinical Research Unit and biochemical assays were carried in Liggins laboratories - including a new technique developed to measure salivary cortisol by mass spectrometry.
“We found that physiologic function was not altered in children exposed to repeat compared with single doses of antenatal glucocorticoids, suggesting that adverse effects on long-term health are very unlikely. These results should encourage clinicians to make repeat dose therapy more widely available, with important benefits for preterm babies,” says Chris.
Chris says his PhD experience was also valuable in improving his academic writing and oral presentation skills.
Chris’ thesis was selected from 312 doctoral degrees completed at The University of Auckland in 2012 to receive one of five Vice-Chancellor’s Prizes for Best Doctoral Thesis. Read more.
He has also won a Student Research Award from the Society for Pediatric Research USA and a Young Investigator Award from the Pediatric Society of New Zealand.
“Perinatal interventions are important because there is potential that effects may continue throughout the life-span. Therefore, long-term follow-up in clinical trials is essential,” he says.
The project was funded by grants from the Health Research Council of NZ, National Health and Medical Research Council (Australia) and the Auckland Medical Research Foundation (AMRF). Through his PhD Chris was supported by a clinical research fellowship from the AMRF and a doctoral scholarship from the Liggins Institute.
Following his PhD, Chris spent two years completing his clinical training in Melbourne, Australia, working as a Clinical Fellow in Neonatology and Perinatal Medicine. He has since returned to work as a specialist neonatologist in the neonatal intensive care unit at Auckland Hospital’s National Women’s Health while continuing research with the Liggins Institute’s LiFePATH research group. Current research interests include the effects of neonatal hypoglycaemia, maternal diabetes and intrauterine growth restriction on infant and long-term health outcomes.
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