Suttie Michael, Wetherill Leah, Jacobson Sandra W, Jacobson Joseph L, Hoyme H Eugene, Sowell Elizabeth R, Coles Claire, Wozniak Jeffrey R, Riley Edward P, Jones Kenneth L, Foroud Tatiana, Hammond Peter
Nuffield Department of Obstetrics and Gynaecology , University of Oxford, Oxford, United Kingdom.
Big Data Institute , University of Oxford, Oxford, UK.
Alcohol Clin Exp Res. 2017 Aug;41(8):1471-1483. doi: 10.1111/acer.13429. Epub 2017 Jul 10.
Our objective is to help clinicians detect the facial effects of prenatal alcohol exposure by developing computer-based tools for screening facial form.
All 415 individuals considered were evaluated by expert dysmorphologists and categorized as (i) healthy control (HC), (ii) fetal alcohol syndrome (FAS), or (iii) heavily prenatally alcohol exposed (HE) but not clinically diagnosable as FAS; 3D facial photographs were used to build models of facial form to support discrimination studies. Surface curvature-based delineations of facial form were introduced.
(i) Facial growth in FAS, HE, and control subgroups is similar in both cohorts. (ii) Cohort consistency of agreement between clinical diagnosis and HC-FAS facial form classification is lower for midline facial regions and higher for nonmidline regions. (iii) Specific HC-FAS differences within and between the cohorts include: for HC, a smoother philtrum in Cape Coloured individuals; for FAS, a smoother philtrum in Caucasians; for control-FAS philtrum difference, greater homogeneity in Caucasians; for control-FAS face difference, greater homogeneity in Cape Coloured individuals. (iv) Curvature changes in facial profile induced by prenatal alcohol exposure are more homogeneous and greater in Cape Coloureds than in Caucasians. (v) The Caucasian HE subset divides into clusters with control-like and FAS-like facial dysmorphism. The Cape Coloured HE subset is similarly divided for nonmidline facial regions but not clearly for midline structures. (vi) The Cape Coloured HE subset with control-like facial dysmorphism shows orbital hypertelorism.
Facial curvature assists the recognition of the effects of prenatal alcohol exposure and helps explain why different facial regions result in inconsistent control-FAS discrimination rates in disparate ethnic groups. Heavy prenatal alcohol exposure can give rise to orbital hypertelorism, supporting a long-standing suggestion that prenatal alcohol exposure at a particular time causes increased separation of the brain hemispheres with a concomitant increase in orbital separation.
我们的目标是通过开发基于计算机的面部形态筛查工具，帮助临床医生检测产前酒精暴露对面部的影响。
所有415名受试者均由专业的畸形学家进行评估，并分为以下几类：（i）健康对照（HC）；（ii）胎儿酒精综合征（FAS）；（iii）产前酒精暴露严重（HE）但临床未诊断为FAS；使用三维面部照片构建面部形态模型，以支持鉴别研究。引入了基于表面曲率的面部形态描绘。
（i）两个队列中FAS、HE和对照亚组的面部生长情况相似。（ii）临床诊断与HC - FAS面部形态分类之间的队列一致性在面部中线区域较低，在非中线区域较高。（iii）队列内部和队列之间特定的HC - FAS差异包括：对于HC组，科伊桑人（南非开普地区的混血人种）人中更平滑；对于FAS组，白种人人中更平滑；对于对照 - FAS人中差异，白种人更具同质性；对于对照 - FAS面部差异，科伊桑人更具同质性。（iv）产前酒精暴露引起的面部轮廓曲率变化在科伊桑人中比在白种人中更具同质性且变化更大。（v）白种人HE亚组分为具有类似对照和类似FAS面部畸形的聚类。科伊桑人HE亚组在非中线面部区域也有类似划分，但中线结构不明显。（vi）具有类似对照面部畸形的科伊桑人HE亚组表现为眶距增宽。
面部曲率有助于识别产前酒精暴露的影响，并有助于解释为什么不同面部区域在不同种族群体中导致对照 - FAS鉴别率不一致。产前大量酒精暴露可导致眶距增宽，支持了长期以来的一种观点，即特定时期的产前酒精暴露会导致脑半球分离增加，同时眶间距也会增加。
