Abstract
BackgroundFetal facial development is essential not only for postnatal bonding between parents and child, but also theoretically for the study of the origins of affect. However, how such movements become coordinated is poorly understood. 4-D ultrasound visualisation allows an objective coding of fetal facial movements.Methodology/FindingsBased on research using facial muscle movements to code recognisable facial expressions in adults and adapted for infants, we defined two distinct fetal facial movements, namely “cry-face-gestalt” and “laughter- gestalt,” both made up of up to 7 distinct facial movements. In this conceptual study, two healthy fetuses were then scanned at different gestational ages in the second and third trimester. We observed that the number and complexity of simultaneous movements increased with gestational age. Thus, between 24 and 35 weeks the mean number of co-occurrences of 3 or more facial movements increased from 7% to 69%. Recognisable facial expressions were also observed to develop. Between 24 and 35 weeks the number of co-occurrences of 3 or more movements making up a “cry-face gestalt” facial movement increased from 0% to 42%. Similarly the number of co-occurrences of 3 or more facial movements combining to a “laughter-face gestalt” increased from 0% to 35%. These changes over age were all highly significant.SignificanceThis research provides the first evidence of developmental progression from individual unrelated facial movements toward fetal facial gestalts. We propose that there is considerable potential of this method for assessing fetal development: Subsequent discrimination of normal and abnormal fetal facial development might identify health problems in utero.
Highlights
The development of complex facial movements in the uterus is essential for a number of functions after birth, such as the infant sucking movement involved in feeding from breast or bottle [1], jaw and tongue movements necessary for speech [2] and movements in the face necessary for facial expressions
Does the complexity of facial movement increase with fetal age? If so, do facial gestalts, one showing facial movements associated with positive and the other with negative emotions in babies and children (e.g. ‘‘laughter’’ gestalt or ‘‘cry-face’’-gestalt) emerge from the second to third trimester of pregnancy? These hypotheses were explored with two healthy fetuses using frame by frame coding of facial actions in order to develop a reliable and reproducible method for fetal facial movement coding
Using a method designed for the eye brow region of the face [24] which defined movements in the upper face in relation to Facial Action Coding System (FACS) [22] as well as the web resource Artnatomy [25], we identified 19 fetal facial movements which could be observed and reliably coded from fetal 4 D scans
Summary
The development of complex facial movements in the uterus is essential for a number of functions after birth, such as the infant sucking movement involved in feeding from breast or bottle [1], jaw and tongue movements necessary for speech [2] and movements in the face necessary for facial expressions. Fetal motor development affects general motor and specific oral-motor function in neonates [3] and and their facial expressions. Fetal facial development is essential for postnatal bonding between parents and child, and theoretically for the study of the origins of affect. How such movements become coordinated is poorly understood. 4-D ultrasound visualisation allows an objective coding of fetal facial movements How such movements become coordinated is poorly understood. 4-D ultrasound visualisation allows an objective coding of fetal facial movements
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