Overview

The New Zealand obstetrician and endocrinologist Graham (Mont) Liggins and pediatrician Ross Howie showed a reduction in the incidence of respiratory distress syndrome (RDS) in those preterm babies receiving corticosteroids before birth in the first randomized controlled trial (RCT), published in 1972. This Witness Seminar, chaired by Dr Edmund Hey, discussed the influence of Liggins and Howie's work. Other topics considered were the work by Avery and Kotas, who confirmed and extended Liggins and Howie's original observation of induction of pulmonary surfactant in lambs; Dr Patricia Crowley's first systematic review of four RCTs published in 1981, later preserved in the Cochrane Collaboration Logo; the small uptake in practice until the Royal College of Obstetricians and Gynecologists issued a guideline on its use in 1992; the Auckland trial follow-ups; trials on optimum drug, dose and number of courses; potential adverse effects in adults; preservation of trial data; and the early use of cost-benefit analysis of this therapy, accompanied by the growth of health economics, systematic reviews and evidenced-based medicine to evaluate treatments. Other participants include Dr Mary Ellen (Mel) Avery, Sir Iain Chalmers, Dr Patricia Crowley, the late Professor Harold Gamsu, Professor Jane Harding, Professor Miranda Mugford, Professor Richard Lilford, Professor Ann Oakley, Professor Dafydd Walters and Mr John Williams. The volume contains five appendices, including memoirs from both Liggins and Howie, an evaluation of Liggins' Wellcome Trust grant, and the protocol of the 1975 UK multicentre study of betamethasone.

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