Facial alterations associated with alcohol, marijuana and cocaine in 80 children assessed by photo analysis and landmark digitization
Astley, Susan Jean, 1955-
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A few reports have suggested that marijuana exposure during gestation may produce a recognizable facial appearance that is similar to the face of fetal alcohol syndrome (FAS). A previous study has demonstrated that the face of FAS can be accurately recognized by dysmorphologists through systematic evaluation of facial photographs and that facial phenotype could be described through a computer analysis of facial landmarks. This method is now applied to the analysis of facial form relative to fetal marijuana exposure with additional assessment relevant to fetal alcohol and cocaine exposures.A photo set of 80 children, aged five to seven years, was compiled. The individuals were identified from a population of 1100 mother/child pairs that had participated in a prospective study investigating the role of maternal diet, drinking and other drug use during lactation on infant growth and development. The mothers had completed a questionnaire during pregnancy and a personal interview at one month postpartum which detailed, among other things, alcohol, marijuana and cocaine use just before and/or during pregnancy. Forty of the children had mothers who reported marijuana use at least once per week during the first trimester. Forty children with no gestational exposure to marijuana were group-matched to the exposed group on maternal use of alcohol in the month prior to and during pregnancy and infant sex, race and age.A dysmorphologist, (S.K.C.) analyzed the photos descriptively and by direct measurements. The photos were then marked for computerized digitization and analyzed morphometrically.Neither the dysmorphic assessments nor the computer analysis could distinguish facial anomalies related to marijuana exposure. Both the dysmorphologist and the computer were able to identify children exposed to two to four ounces of alcohol per day (n = 12) as having facial features of FAS. Cocaine exposure was found to be independently associated with mild facial dysmorphic features of hypertelorism and midfacial flattening. Of 1073 mother/infant pairs that had participated in the original prospective study, the proportion of female offspring appeared to decrease with increasing maternal consumption of alcohol, cocaine and marijuana early in gestation.
- Epidemiology