The subtle facial signs of prenatal exposure to alcohol: An anthropometricapproach

Objectives: The purpose was to demonstrate that an objective, multivariate case definition of fetal alcohol syndrome (FAS) and partial fetal alcohol s yndrome (PFAS) can be derived by means of craniofacial anthropometry. Study design: Craniofacial measurements (n = 21) were taken of 100 individu als who had been exposed to alcohol before birth (41 FAS, 59 PFAS) and 31 m embers of a control group. Multivariate discriminant analysis was used to i dentify craniofacial measurements that best differentiated the 3 groups (FA S, PFAS, and control). Results: Both the FAS and PFAS groups had a unique craniofacial phenotype t hat could be accurately discriminated from that of the control group. Stepw ise discriminant analysis identified 6 craniofacial measurements that could differentiate individuals with and without prenatal alcohol exposure with 96% accuracy, 98% sensitivity, and 90% specificity. Conclusions: Individuals with FAS and PFAS have a distinctive facial phenot ype that can be characterized anthropometrically. The phenotypic case defin ition could be used as a screening tool to identify individuals prenatally exposed to alcohol who do not exhibit a "classic" FAS phenotype but exhibit a more subtle craniofacial dysmorphia.