A case definition and photographic screening tool for the facial phenotype of fetal alcohol syndrome☆,☆☆,★,★★
Section snippets
Overview
Frontal facial photographs of 42 subjects with FAS (birth to 27 years of age) were pair matched on age, race, and gender to the frontal facial photographs of two randomly selected subjects without FAS (n = 84). The 126 patients were randomly divided into two groups (n = 63 per group) balanced on age, gender, and race. Stepwise discriminant analysis was used to identify the facial feature(s) that best differentiated the subjects with and without FAS in group 1. The multivariate discriminant
RESULTS
The total population of 42 subjects with FAS and 84 control subjects were successfully balanced on gender, race, and age at the time the photograph was taken (Table II). The age distribution of the study population was as follows: birth to 2 months (n = 1), 3 to 12 months (n = 4), 1 to 5 years (n = 43), 6 to 10 years (n = 46), 11 to 15 years (n = 22), 16 to 20 years (n = 6), and 20+ years (n = 4). No two subjects with FAS had an identical pattern of facial features. The variation of phenotypic
DISCUSSION
This study has demonstrated that a phenotypic case definition of FAS can be derived from frontal facial photographs of individuals with FAS. It has also illustrated how this case-definition and methodologic approach can be used to develop an accurate and precise screening tool and diagnostic aid. The discriminating cluster of facial features identified from the photographs are identical to the facial features identified by direct facial measurement in a previous study,7 thus supporting the
Acknowledgements
We express our thanks to Cliff Astley for his computer programming support, Erik McArthur for the computer capture of all photographic images, and Ann P. Streissguth, PhD, and Hans-Ludwig Spohr, MD, for their contribution of photographs to this study.
References (15)
- et al.
Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies
Drug Alcohol Depend
(1987) - et al.
Prenatal alcohol exposure and long-term developmental consequences
Lancet
(1993) - et al.
Recognition of fetal alcohol syndrome in early infancy
Lancet
(1973) - et al.
The fetal alcohol syndrome
N Engl J Med
(1978) Seventh Special Report to the U.S. Congress on Alcohol and Health
(1990)- et al.
Children of alcoholic mothers
Pediatrician
(1987) - et al.
Tracking the prevalence of FAS
Alcohol Health Research World
(1994)
Cited by (0)
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From the Department of Epidemiology, School of Public Health and Community Medicine, and the Department of Pediatrics, School of Medicine, University of Washington, Seattle
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Supported in part by the Chevez FAS Fund at Children's Hospital and Medical Center, Seattle, Wash.
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Reprint requests: Susan J. Astley, PhD, Children's Hospital and Medical Center, 4800 Sand Point Way N.E., Seattle WA 98105.
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0022-3476/96/$5.00 + 0 9/20/74002