Using facial morphology traits related to attention problems in children to identify prenatal exposure history

Abstract Brain development and face morphology are related through underlying biological mechanisms, namely embryonic neuroectodermal processes. This study examined whether the facial parameters identified in children can help understand the neurodevelopmental impact of prenatal exposures on child behavior. We studied 9- to 10-year-old children of European descent from Generation R Study ( N = 2,779) with three-dimensional face photographs. With an AI model of a 3D graph autoencoder, each facial shape was compressed into 200 traits representing facial morphology. We examined associations of traits with internalizing and externalizing behaviors and attention problems. Next, select prenatal substance and micronutrient exposures were related to facial traits using adjusted linear regression analyses. We identified a robust association between one specific facial trait and attention problem scores ( β = −1.47, p = 0.038). This trait features chin retrusion, mild nasal contour variation, nose tip protrusion, and overall facial asymmetry. Higher prenatal vitamin D and folic acid concentrations were associated with more facial curvature ( β = 0.0001, 95%CI: 0.00001 to 0.0002, p = 0.002; and β = 0.0003, 95%CI: 0.00002 to 0.0005, p = 0.03 accordingly), while prenatal tobacco smoking showed a negative association both until the mother became aware of pregnancy ( β = −0.008, 95%CI: −0.0135 to −0.0014, p = 0.02) and throughout pregnancy ( β = −0.006, 95%CI: −0.0113 to −0.0005, p = 0.03). Findings suggest that facial morphology may serve as a marker of impaired neuroectodermal development. Leveraging its association with attention problems enabled a robust examination of prenatal exposures’ impact. The associations of maternal smoking, vitamin D, and folic acid concentrations with facial morphology provide insights into the origins of neurodevelopment.