Objectives To compare 2D and 3D photography using computerised analysis for earlier detection of craniofacial changes in newborn infants with and without prenatal alcohol exposure.
Method 3D and standard 2D facial photography on newborn infants recruited on the maternity ward and a specialist substance misuse clinic. Mothers complete a questionnaire regarding alcohol consumption during pregnancy.
Analysis of 3D imaging data undertaken by previously described methodology using dense surface modelling (DSM) from which facial profiling can be extracted.
Linear profiles were extracted directly from lateral facial 2D images. Computerised analysis using established methodology is undertaken on the 2D photographs.
Prospective analysis intention: 4 groups: No PNAE (control group – to provide reference values for the model), Low levels of PNAE (<4 units per week), Moderate levels of PNAE (>4 units per week), high levels of PNAE (>11 units per week)
Results (initial pilot group, n=40)
Problems related to photographing newborn infants successfully overcome: technically acceptable 3D image reconstructions subjected to dense surface-modelling. Facial profiling successfully extracted in all infants.
Limited numbers currently mean that statistical comparisons between groups are not valid to produce meaningful results.
Conclusions Pilot analysis shows that technically successful results can be achieved in this difficult to photograph group of patients.
Continued active recruitment ongoing over next 6 months: allowing analysis of several hundred infants and modelling of normal values. This will allow statistical comparisons to be made with the groups who have been exposed to alcohol in pregnancy. Midline facial profiling in particular has been shown in pilot studies to be highly discriminative with an ROC curve value of 0.95 with a relationship between face shape and brain abnormalities.
A strength of this study is the effort made with regard to anonymisation of data collection regarding alcohol consumption likely to help with validity and reliability of this data.
Best estimates for the prevalence of FASD in the UK are between 1%–5% but it is rarely diagnosed. Early diagnosis of FASD has been shown to improve outcome. Techniques such as this may prove to have a role in early diagnosis, screening for exposure, or determining infants at risk of future neurodevelopmental problems.
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