Moderately and late preterms have problem recognizing faces after birth^☆,☆☆

Humans communicate more with our faces than any other creature.

The face is an extremely complex system regulating affective responses. According to Heise,¹ affective responses formed into feelings are the everyday basis for generating cultural events. Thus, the face can be considered as a key element in socialization.

The ability to recognize faces is important for the human social life and attachment behavior, not only as adults but also as a newborn child. This gift is somewhat present already at birth, when infants express a strong interest in face-like figures and can differentiate between facial and non-facial images.

Children born preterm may suffer from different neurodevelopmental problems and neuropsychological disorders than children born full term.^2,3 Prosopagnosia, the inability to recognize faces, also called "face blindness", can be a part of prematurity-related neurodevelopmental disorder spectrum, but also an isolated event. Preterm infants are more likely to suffer from prosopagnosia.⁴ It can have a profound impact of a child's life, as it is a great social handicap, leading to difficulties in making friends and participating in social activities in school, as well as increased levels of anxiety. Thus, it is of great interest to investigate this area of social development, especially among preterm infants.

The article from Pereira et al.⁵ is an original study addressing facial preferences during the first two days of life and comparing the reaction of preterm and term newborn infants to the exposure to natural and distorted faces. Although the predilection to orientate oneself to a natural face had been previously shown in term infants both shortly after birth⁶ and around three month postnatally,⁷ in this study Pereira et al.⁵ focused on a group of late preterm (gestational age 33-36 weeks, mean 35 ± 1.11). An important aspect of the Pereira's study⁵ is its focus on a particular group of subjects, such as the moderately and late preterms, who account for approximately 10% of all births.⁸

The ability to orientate to an image resembling the face of its own species is common among a large variety of vertebrates, including humans, showing similar domain-relevant predispositions shortly after birth.⁹

The relevance and originality of the study presented by Pereira et al. is mainly related to the fact that one group was composed by preterm newborns. The study showed that the ability to distinguish a natural face from an unnatural face is significantly diminished in preterm infants when compared with term infants during the first 48 h.

The authors discussed possible reasons for these findings. The CONSPEC and CONLERN process theories for face recognition were briefly reviewed.¹⁰ An alteration of the CONSPEC, possibly related to a shorter period for haptic exploration by the baby that in turn may influence brain maturation during the last trimester of gestation, may be a possible explanation.^11,12

Other possible explanations may be found in a delayed or eventually impaired development of crucial areas that are responsible for the processing of the information coming from the visual areas in the occipital cortex. These areas include, for example, the gray matter involving the left fusiform, amygdala, and temporal cortex.¹³ These regions are touched by the so-called ventral stream, which is thought to be responsible for object, face, and scene recognition.¹⁴

The study presented by Pereira et al.⁵ adds new insights to the understanding of prematurity-related developmental disorders, which include prosopagnosia.

• ☆
  Please cite this article as: Bartocci M. Moderately and late preterms have problem recognizing faces after birth. J Pediatr (Rio J). 2017;93:4-5.
• ☆☆
  See paper by Pereira et al. in pages 35-9.

References

• ¹
  Heise DR. Understanding events: affect and the construction of social action. New York: Cambridge University Press; 1979.
• ²
  Lampi KM, Lehtonen L, Tran PL, Suominen A, Lehti V, Banerjee PN, et al. Risk of autism spectrum disorders in low birth weight and small for gestational age infants. J Pediatr. 2012;161:830-836.
• ³
  Serenius F, Källén K, Blennow M, Ewald U, Fellman V, Holmström G, et al. Neurodevelopmental outcome in extremely preterm infants at 2.5 years after active perinatal care in Sweden. JAMA. 2013;309:1810-1820.
• ⁴
  Ellis HD. Recognizing faces. Br J Psychol. 1975;66:409-426.
• ⁵
  Pereira SA, Pereira Junior A, Costa MF, Monteiro MV, Almeida VA, Fonseca Filho GG, et al. A comparison between preterm and full-term infants' preference for faces. J Pediatr (Rio J). 2017;93:35-39.
• ⁶
  Goren CC, Sarty M, Wu PY. Visual following and pattern discrimination of face-like stimuli by newborn infants. Pediatrics. 1975;56:544-549.
• ⁷
  Turati C, Valenza E, Leo I, Simion F. Three-month-olds' visual preference for faces and its underlying visual processing mechanisms. J Exp Child Psychol. 2005;90:255-273.
• ⁸
  Centers for Disease Control and Prevention. National Center for Health Statistics. CDC Wonder online database [accessed 04.08.16]. Available from: http://wonder.cdc.gov/natality.html
  » http://wonder.cdc.gov/natality.html
• ⁹
  Rosa Salva O, Farroni T, Regolin L, Vallortigara G, Johnson MH. The evolution of social orienting: evidence from chicks (Gallus gallus) and human newborns. PLoS ONE. 2011;6:e18802.
• ¹⁰
  Morton J, Johnson MH. CONSPEC and CONLERN: a two-process theory of infant face recognition. Psychol Rev. 1991;98:164-181.
• ¹¹
  Shibata M, Fuchino Y, Naoi N, Kohno S, Kawai M, Okanoya K, et al. Broad cortical activation in response to tactile stimulation in newborns. Neuroreport. 2012;23:373-377.
• ¹²
  Kurjak A, Azumendi G, Vecek N, Kupesic S, Solak M, Varga D, et al. Fetal hand movements and facial expression in normal pregnancy studied by four-dimensional sonography. J Perinat Med. 2003;31:496-508.
• ¹³
  Frie J, Padilla N, Ådén U, Lagercrantz H, Bartocci M. Extremely preterm-born infants demonstrate different facial recognition processes at 6-10 months of corrected age. J Pediatr. 2016;172:.
• ¹⁴
  Braddick O, Atkinson J. Development of human visual function. Vision Res. 2011;51:1588-1609.

Publication Dates

• Publication in this collection
  Jan/Feb 2017