FACIAL DIMENSIONS IN NORMAL TERM NEONATES BORN IN THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU, SOUTH EASTERN NIGERIA

Abstract

The measurement of facial parameters is important. These parameters
include the inner canthal distance, outer canthal distance, palpebral fissure
length, philtrum length and oral commissural length. These parameters are
affected by age, sex, race, ethnicity, geographical location, chromosomal
defect and congenital infections.
A cross-sectional study of facial dimensions in normal term neonates
delivered at the University of Nigeria Teaching Hospital (UNTH), Enugu was
carried out. Three hundred and thirty-two consecutive normal term newborn
males and females were studied. One hundred and sixty-six were males and
equal numbers were females. The measurements of the facial parameters
were taken within 72 hours of delivery. The transparent film deduced by
Feingold for ear measurement and extrapolated for measurement of facial
parameters by Omotade was used for this study. The data obtained was
entered into a computer database and analyzed using descriptive and
inferential statistics (statistical package for the social sciences).
The mean gestational ages for UNTH male and female newborns were
39.27wks ± 1.22wks and 39.10wks ± 1.22wks, respectively. The mean birth
weights of UNTH male and female newborns were 3.34kg ± 0.39kg and
3.27kg ± 0.42kg, respectively. It was found that at a similar gestational age
and birth weight, the males had a wider mean occipitofrontal circumference
(OFC) than the females (males = 34.86cm ± 1.19cm, females = 34.56cm ±
1.32cm, p = 0.03). There was no significant difference between the mean
outer canthal distances of the male and female newborns (male = 51.75mm
± 3.78mm, females = 51.10mm ± 3.15mm, p = 0.095) and there was no
significant difference between the means of the inner canthal distance
between the 2 groups (male = 16.50mm ± 1.51mm, female = 16.49mm ±
1.27mm, p = 0.948). The mean palpebral fissure length of the male
newborns was significantly larger than that of the female newborns (male =
17.99mm ± 1.36mm, female = 17.30mm ± 1.31mm, p = 0.000). The mean
oral commissural distance of the male newborns was significantly larger
than that of the female newborns (males = 22.17mm ± 2.15mm, female =
21.47mm ± 1.73mm, p=0.001). The mean philtrum length of the male
newborns was also significantly longer than that of the female newborns
(male = 10.84mm ± 1.33mm, female = 10.36mm ± 1.38mm, p = 0.001).
Comparing the findings in this study with those from Ibadan revealed
marked differences in their facial dimensions. The mean gestational age of
UNTH newborns was not significantly different from the mean gestational
age of Ibadan newborns (Ibadan = 39.2wks ± 1.3weeks, Enugu = 39.18wks ±
1.2weeks, p = 0.857). The mean birth weight of Enugu newborns was
significantly higher than the mean birth weight of Ibadan newborns (Ibadan
= 3.08kg ± 0.32kg, Enugu = 3.31kg ± 0.40kg, p = 000). However, the mean
outer-canthal distance of Ibadan newborns was significantly longer than
that of Enugu newborns (Ibadan = 61mm ± 4mm, UNTH = 51.4mm ±
3.5mm, p = 0.000). The mean inner canthal distance of Ibadan newborns
was significantly longer than that of Enugu newborn (Ibadan = 21.0 ± 2mm,
UNTH = 16.5 ± 1.4mm, p = 0.000). The mean palpebral fissure length of
Ibadan newborns was significantly longer than that of Enugu newborn
(Ibadan = 20 ± 2mm, UNTH = 17.7 ± 1.4, p = 0.000). The same was found in
their oral commissural length (Ibadan = 31 ± 3mm, UNTH = 21.8 ± 2mm, p =
0.000). Enugu newborns were found to have significantly longer philtrum
than those of Ibadan newborns (Ibadan = 8 ± 1mm, UNTH = 10.16 ± 1.4mm,
p = 0.000).
Comparison with Cardiff newborns also showed marked differences.
Cardiff newborns had significantly higher mean birth weight than Enugu
newborns (Cardiff = 3.4 ± 0.5kg, UNTH = 3.31 ± 0.4kg, p = 0.016). When
compared with the Cardiff newborns, the Enugu male newborns had
significantly smaller mean OFC (Cardiff = 35.1 ± 1.4cm, UNTH = 34.7 ±
1.3cm, p = 0.000). The mean outer-canthal distance of Cardiff newborns was
significantly longer than that of Enugu newborns (Cardiff = 63 ± 4mm,
UNTH = 51.4 ± 3.5mm p = 0.000). The mean inner-canthal distance of
Cardiff newborns was also found to be wider than that of Enugu newborns
(Cardiff = 22 ± 2mm, UNTH = 16.5 ± 1.4mm, P = 0.00) and mean palpebral
fissure length of newborns in Cardiff was also longer than that of Enugu
newborns (Cardiff = 20 ± 2mm, UNTH = 17.6 ± 1.4, p = 0.00).
In conclusion, the study demonstrated sex, ethnic, environmental and
geographical differences in facial dimensions of newborns. The facial
anthropometric values of the male and female newborns delivered in UNTH,
Enugu were generally different from those of newborns from centers in other
parts of the world.
Therefore, it is recommended that facial dimensions of newborns be
classified with respect to locally generated means since these parameters are
affected by sex, ethnic and environmental factors.

FACIAL DIMENSIONS IN NORMAL TERM NEONATES BORN IN THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU, SOUTH EASTERN NIGERIA