JPediatr(RioJ).2017;93(1):4---5
www.jped.com.br
EDITORIAL
Moderately
and
late
preterms
have
problem
recognizing
faces
after
birth
夽
,
夽夽
Prematuros
moderados
e
tardios
apresentam
problemas
em
reconhecer
rostos
após
o
nascimento
Marco
Bartocci
KarolinskaUniversityHospital,AstridLindgren’sChildren’sHospital,MedicalDirectorNeonatologyDepartment,Solna,Sweden
Humanscommunicatemorewithourfacesthan anyother creature.
The face is an extremely complex system regulat-ing affective responses. According to Heise,1 affective
responses formed intofeelings arethe everyday basis for generatingculturalevents.Thus,thefacecanbeconsidered asakeyelementinsocialization.
Theabilitytorecognizefacesisimportantforthehuman sociallifeandattachmentbehavior,notonlyasadultsbut also as a newborn child. This gift is somewhat present alreadyatbirth,wheninfants expressastrong interestin face-likefiguresand candifferentiate betweenfacialand non-facialimages.
Childrenbornpretermmaysufferfromdifferent neuro-developmentalproblems andneuropsychological disorders thanchildren born full term.2,3 Prosopagnosia, the
inabil-ityto recognize faces, alsocalled ‘‘face blindness’’,can beapartofprematurity-relatedneurodevelopmental disor-derspectrum,but alsoan isolatedevent.Preterm infants aremorelikelytosuffer fromprosopagnosia.4 Itcanhave
aprofound impact of achild’s life, asit is a greatsocial
夽 Please cite this article as: Bartocci M. Moderately and late
pretermshaveproblemrecognizingfacesafterbirth.JPediatr(Rio
J).2017;93:4---5.
夽夽SeepaperbyPereiraetal.inpages35---9.
E-mails:marco.bartocci@ki.se,marco.bartocci@karolinska.se
handicap,leadingtodifficultiesinmakingfriendsand par-ticipatinginsocialactivitiesinschool,aswellasincreased levelsofanxiety.Thus,itisofgreatinteresttoinvestigate thisareaofsocialdevelopment,especiallyamongpreterm infants.
The article from Pereira et al.5 is an original study
addressing facial preferencesduring the first twodays of lifeandcomparingthereactionofpretermandterm new-borninfantstotheexposuretonaturalanddistortedfaces. Although the predilection toorientate oneself to a natu-ral 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(gestationalage33---36weeks,mean35±1.11).An important aspect of the Pereira’s study5 is its focuson a
particular group of subjects, such asthe moderately and late preterms, who accountfor approximately 10% of all births.8
Theabilitytoorientatetoanimageresemblingtheface ofitsownspeciesiscommonamongalargevarietyof verte-brates,includinghumans,showingsimilardomain-relevant predispositionsshortlyafterbirth.9
Therelevanceandoriginalityofthestudypresentedby Pereiraetal.ismainlyrelatedtothefactthatonegroupwas composedbypretermnewborns.Thestudyshowedthatthe abilitytodistinguishanaturalfacefromanunnaturalfaceis significantlydiminishedinpreterminfantswhencompared withterminfantsduringthefirst48h.
http://dx.doi.org/10.1016/j.jped.2016.10.002
0021-7557/©2016SociedadeBrasileiradePediatria.PublishedbyElsevierEditoraLtda.ThisisanopenaccessarticleundertheCCBY-NC-ND
Moderatelyandlatepretermshaveproblemrecognizingfacesafterbirth 5
The authors discussed possible reasons for these find-ings.TheCONSPECandCONLERNprocesstheoriesfor 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 maturationduringthelasttrimesterofgestation,maybea possibleexplanation.11,12
Other possibleexplanations maybefound inadelayed or eventually impaired development of crucial areas that areresponsiblefortheprocessingoftheinformation com-ingfromthevisualareasintheoccipitalcortex.Theseareas include, for example, the gray matter involving the left fusiform, amygdala,andtemporal cortex.13 Theseregions
are touched by the so-called ventral stream, which is thought to be responsible for object, face, and scene recognition.14
ThestudypresentedbyPereiraetal.5addsnewinsights
totheunderstandingofprematurity-relateddevelopmental disorders,whichincludeprosopagnosia.
Conflicts
of
interest
Theauthordeclaresnoconflictsofinterest.
References
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10.MortonJ,JohnsonMH.CONSPECandCONLERN:atwo-process theoryofinfantfacerecognition.PsycholRev.1991;98:164---81.
11.ShibataM,FuchinoY,NaoiN,KohnoS,KawaiM,Okanoya K, etal.Broadcorticalactivationinresponsetotactilestimulation innewborns.Neuroreport.2012;23:373---7.
12.KurjakA,AzumendiG,VecekN,KupesicS,SolakM,VargaD, etal.Fetal handmovements andfacialexpressioninnormal pregnancystudied byfour-dimensional sonography. JPerinat Med.2003;31:496---508.
13.FrieJ,PadillaN,ÅdénU,LagercrantzH,BartocciM.Extremely preterm-borninfantsdemonstratedifferentfacialrecognition processesat6---10monthsofcorrectedage.JPediatr.2016;172, 96---102.e1.
