A fascinating research project is examining whether the covering of faces during the COVID-19 pandemic had any impact on the facial perception of babies who spent time in neonatal intensive care (NICU).
While newborns are known to show a preference for faces, it is thought that continued exposure to faces after birth, particularly those of their parents, is critical for developing the brain networks that will help the child navigate social situations later in life.
During the pandemic, mandatory mask-wearing in most intensive care units posed a physical barrier to facial exposure and perception among NICU patients, who are often born premature.
Face perception in vulnerable babies
The Babyface Study aimed to assess the impact of face masks on face perception in these vulnerable babies.
The study, published in the journal Scientific Reports was led by Associate Professor Flora Wong, Group Head of the Neonatal Brain Protection group at Hudson Institute of Medical Research, a Consultant Neonatologist at Monash Children’s Hospital and a senior research fellow in the School of Clinical Sciences at Monash Health, and Dr Robin Laycock from RMIT.
It assessed 24 preterm (23-30 weeks of gestation at birth) and 24 full-term infants at six months of post-term age, using functional near-infrared spectroscopy. This non-invasive brain imaging technique measures brain activity by detecting changes in blood oxygenation.
The infants viewed alternating five second trials of images of full or masked happy faces, interspersed with 15 second baseline trials. The control group – babies born at full term – showed higher brain responses and activations than preterm infants to full faces.
According to Dr Wong, the study’s findings “reveal lower brain activation in preterm compared to term infants in the inferior-frontal region of the brain, which is important for face and emotion processing,” she said.
Preterm children and neurodevelopmental disorders
Preterm infants are known to have a higher risk of socio-cognitive dysfunction, which disrupts their understanding and response to social information, leading to reduced social engagement, attention and behaviour like cooperation and sharing.
Preterm children also have an increased incidence of neurodevelopmental disorders such as autism spectrum disorder and attention-deficit/hyperactivity disorder, both of which involve socio-cognitive dysfunction and are often characterised by atypical responses to faces, such as impaired eye contact and difficulty in reading facial expressions.
“We already know that while full term infants within 48 hours after birth demonstrate preferential looking at natural compared to distorted face images, preterm infants do not differentiate between these stimuli,” said Dr Laycock. “Now, our study has also revealed that the term-born infants showed higher brain activations for full than masked faces, but preterm infants’ brain responses do not differ between these faces.”
The study will further assess the participants in the study at two years of age. “The result will reveal whether the brain response to face perception at early infancy is related to socio-cognitive deficits in preterm infants, and its potential as an early marker of neurodevelopmental outcomes,” Dr Wong said.
“Current early follow-up after preterm birth focuses on motor development, to screen for motor disorders such as cerebral palsy at 3-4 months of post-term age. Early socio-cognitive assessment remains limited and may be overlooked until a later age.”
