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Palmar Creases: Classification, Reliability and Relationships to Fetal Alcohol Spectrum Disorders (FASD)
Insights
This study found that while palmar creases can be reliably classified, their patterns are not associated with fetal alcohol spectrum disorders (FASD). This suggests creases may not be a reliable indicator of prenatal alcohol exposure.
Area of Science:
- Dermatoglyphics
- Developmental biology
- Medical diagnostics
Background:
- Palmar creases form early in fetal development, leading to speculation about their use as indicators of developmental insults.
- Deviations in palmar crease patterns have been hypothesized to correlate with various developmental conditions.
- Fetal alcohol spectrum disorders (FASD) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy.
Purpose of the Study:
- To compare the efficacy and reliability of two distinct methods for coding palmar crease patterns (M1 and M2).
- To investigate the potential relationship between specific palmar crease patterns and the presence of fetal alcohol spectrum disorders (FASD).
Main Methods:
- Bilateral palm prints were collected from 237 individuals diagnosed with FASD and 190 controls using a carbon paper and tape method.
- Two coding methods (M1: classifying simian and Sydney line variants; M2: counting radial crease origins) were applied to all prints.
- Reliability of coding methods was assessed through intra- and inter-observer Kappa coefficients on a subset of prints.
Main Results:
- Both coding methods demonstrated reliable intra-observer classifications (Kappa: 0.804-0.910).
- Inter-observer reliability was higher for M2 (Kappa: 0.647-0.757) compared to M1 (Kappa: 0.582-0.623).
- Analysis of 427 palm prints revealed no statistically significant relationship between palmar crease variants and FASD, even after controlling for sex and ethnicity.
Conclusions:
- Palmar crease patterns can be classified with good reliability using established methods.
- The study found no evidence to support the hypothesis that palmar crease patterns are altered by fetal alcohol exposure.
- Palmar crease analysis may not serve as a diagnostic marker for fetal alcohol spectrum disorders.
Abstract:
A normal human palm contains 3 major creases: the distal transverse crease; the proximal transverse crease; and the thenar crease. Because permanent crease patterns are thought to be laid down during the first trimester, researchers have speculated that deviations in crease patterns could be indicative of insults during fetal development. The purpose of this study was twofold: (1) to compare the efficacy and reliability of two coding methods, the first (M1) classifying both "simiana" and Sydney line variants and the second (M2) counting the total number of crease points of origin on the radial border of the hand; and (2) to ascertain the relationship between palmar crease patterns and fetal alcohol spectrum disorders (FASD). Bilateral palm prints were taken using the carbon paper and tape method from 237 individuals diagnosed with FASD and 190 unexposed controls. All prints were coded for crease variants under M1 and M2. Additionally, a random sample of 98 matched (right and left) prints was selected from the controls to determine the reliabilities of M1 and M2. For this analysis, each palm was read twice, at different times, by two readers. Intra-observer Kappa coefficients were similar under both methods, ranging from 0.804-0.910. Inter-observer Kappa coefficients ranged from 0.582-0.623 under M1 and from 0.647-0.757 under M2. Using data from the entire sample of 427 prints and controlling for sex and ethnicity (white v. non-white), no relationship was found between palmar crease variants and FASD. Our results suggest that palmar creases can be classified reliably, but palmar crease patterns may not be affected by fetal alcohol exposure.
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