Research improving lives
Dr Chris Lear
Improving parents' hopes for safer births and healthier babies
Every parent hopes for a safe birth. For most families, labour ends with the arrival of a healthy baby. But for a small number, complications during birth can lead to oxygen deprivation, causing brain injury that may result in lifelong disability or even death. For Dr Christopher Lear, understanding how and why this happens has become a life’s work. His motivation is both professional and personal.
As a medical student and researcher, Chris became fascinated by the extraordinary adaptations that allow babies to survive the challenges of labour. He was also inspired by the work of his mentors, Professors Laura Bennet and Alistair Gunn, whose discoveries have changed the care of newborns around the world. Yet there was another reason he felt drawn to this field.
“My elder sister has dyspraxia, a developmental disorder, and so the chance to contribute towards understanding the origins of neurodevelopmental disability meant a great deal to me on a personal level.”
Today, Chris is a clinician-scientist at the University of Auckland and Auckland City Hospital, combining frontline medical training with a research programme focused on preventing brain injury around the time of birth. His goal is simple: identify babies at risk early enough for clinicians to intervene before permanent injury occurs.
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That challenge is more urgent than many people realise.
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Around 70 babies in New Zealand each year develop brain injury following oxygen deprivation during birth. The condition, known as hypoxic-ischaemic encephalopathy, can lead to cerebral palsy, developmental disability, learning difficulties and, in the most severe cases, death. Families can face a lifetime of medical, emotional and financial challenges.
For decades, clinicians have relied on fetal heart rate monitoring during labour to determine whether a baby is coping well or beginning to struggle. Yet interpreting
those patterns remains surprisingly difficult.
“One of the most rewarding aspects of this work is that every improvement in our understanding gives us another opportunity to prevent injury before it happens. If we can identify babies at risk earlier, we can help give them the safest possible start to life.”
Dr Chris Lear explains.
What his team discovered was both surprising and important.
One of Chris’ landmark publications challenged traditional explanations for fetal heart rate changes during labour. Rather than supporting widely taught theories that had shaped clinical thinking for generations, the research demonstrated that many of these heart rate patterns are driven by an ancient protective reflex known as the peripheral chemoreflex. This reflex helps direct blood and oxygen to vital organs when oxygen levels begin to fall.
The findings have helped reshape understanding of what clinicians are actually seeing when they monitor a baby’s heart rate during labour.
“Our research showed that some of the explanations clinicians have relied on for years were incomplete,” Chris says, “if we want to identify babies at risk of injury, we first need to understand what these signals truly mean.”
His work did not stop there. Another area of focus has been the interaction between oxygen deprivation and high blood glucose levels.
Mothers at risk of premature birth are often treated with antenatal glucocorticoids, medications that can be lifesaving for babies by helping their lungs mature more quickly. However, Chris’ research revealed a more complex picture. His studies found that elevated glucose levels associated with these treatments could worsen brain injury when a baby was also exposed to severe oxygen deprivation. The findings challenged assumptions that higher glucose levels might be protective and instead suggested that excess glucose may increase vulnerability to injury under specific circumstances.
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One publication in particular represented a significant breakthrough.
In 2025, Chris demonstrated that dexamethasone-induced hyperglycaemia before a period of oxygen deprivation could promote severe cystic injury in the developing brain. Importantly, the research identified hyperglycaemia itself as a key driver of harm. This finding opened new avenues for understanding why some babies experience worse outcomes than others and highlighted glucose control as a potentially important factor in protecting vulnerable newborns.
For families affected by diabetes in pregnancy, the implications could be profound. Current AMRF-funded research is building on these findings by exploring whether high glucose levels during labour increase the risk of brain injury when oxygen deprivation occurs. The project is examining how hyperglycaemia changes a baby’s ability to adapt to stress during labour and whether it alters the warning signs clinicians rely on to make decisions.
“We are looking for opportunities to intervene earlier,” Chris says. “If we can identify factors that increase risk and recognise those patterns sooner, we have a better chance of preventing injury before it happens.”
This commitment to clinical translation is a defining feature of his work.
Chris is not interested in research that remains confined to journals and conferences. He wants discoveries to improve clinical care. His studies have helped identify new fetal heart rate biomarkers, refined understanding of labour physiology, and contributed evidence that is changing clinical practice. In 2026, his key findings of what fetal heart rate patterns represent physiologically have been incorporated into the Royal Australian and New Zealand College of Obstetricians and Gynaecologists teaching that is delivered to 9,000 midwives and obstetricians annually across Australia and New Zealand.
He is also collaborating with clinician-researchers across Finland, Japan and the UK to prove his ideas hold up in human populations, while also exploring artificial intelligence and advanced analytics to develop better tools for predicting fetal compromise during labour.
With his Finnish collaborators, he has also led to the finding and publication that existing fetal heart rate monitoring gives few clues to what is known to be another very high risk to babies brains during labour: oxygen deprivation combined with infection.
Chris says, “We’re now taking these observations back to the lab to look for better ways to identify these babies who are at high-risk of brain injury.”
Along the way, his contributions have been widely recognised.
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He has received numerous awards, including the Vice-Chancellor’s Prize for Best Doctoral Thesis, publication excellence awards, and an Editorial Board Fellowship with The Journal of Physiology. Since beginning medical training, he has published more than 50 scientific papers, including many as first or senior author.
Yet the measure of success that matters most remains much simpler. Every improvement in monitoring. Every insight into fetal physiology. Every opportunity to prevent brain injury. Each one means better outcomes for babies and families.
Support from AMRF has played an important role throughout that journey, helping Chris establish himself as an independent researcher while continuing his clinical training. That combination of research and medicine remains central to his vision for the future.
“Research gives us the opportunity to ask questions that cannot be answered at the bedside alone,” he says. “But the goal is always the same. We want to give every baby the safest possible start to life.”
That belief continues to guide his work. Because behind every heart rate trace is a child, a family, and a future worth protecting.
From finding cures and preventing or delaying the onset of disease, to easing the burden of debilitating conditions and improving the quality of people's lives, every breakthrough begins with research.
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