Morphometry of the neonatal fetal alcohol syndrome face from 'snapshots'

Recognition of alcohol-related birth defects is less successful in the neonate than in older children. Clarren et al. (1987) were able to describe the geometry of the FAS face at age 7. To define neonatal facial features of FAS, 3 reference points were used to map 7 frontal and 7 profile landmarks coded as standardized cartesian coordinates. These landmarks were digitized from snapshots of 21 neonates, prospectively diagnosed as FAS blinded for prenatal alcohol exposure, and 76 non-FAS controls. In the controls, race was found to be a significant determinant of landmarks, as expected. Using discriminant analysis and controlling for race, the FAS face was characterized by landmark measurements which correspond to short palpebral fissure, scooping out of the nasal bridge and thin vermilion [F(4,71)-7.8, r sq-30%, p < .01]. Jackknifed sensitivity was 75%, specificity, 79%. These findings suggest that FAS-defining features can be quantified in the neonate via computer-based screening of infants from at-risk pregnancies.