The Babyface Study: the impact of only seeing masked faces during COVID on facial perception in NICU babies
Monash University
While newborns are known to show a preference for faces, it is thought that continued exposure to faces, particularly those of parents, after birth are critical for developing the brain networks that will help the child navigate social situations later in life.
During the COVID-19 pandemic, mandatory mask-wearing in most neonatal intensive care units (NICUs) brought an additional challenge on face exposure and perception in NICU patients, who are often premature. The Babyface Study aimed to assess the impact of face masks on face perception in these vulnerable babies.
Led by Dr Flora Wong, from Monash University and Monash Health, and Dr Robin Laycock from RMIT and published in the journal, Scientific Reports, the study assessed 24 preterm (23-30 weeks gestation at birth) and 24 term-born infants at six months of post-term age, using functional near-infrared spectroscopy. This non-invasive brain imaging technique measures brain activity via the detection of 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 for 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 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 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,” Dr Laycock said.
“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.”
Read full paper in the journal, Scientific Reports: Face perception and impact of face masks at 6 months post-term age in preterm and term infants (The BabyFace Study).
DOI: https://doi.org/10.1038/s41598-026-48027-y
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