Is permanent congenital facial palsy caused by birth trauma?

OBJECTIVE To study the relation between traumatic birth and the development of permanent facial palsy in the newborn. DESIGN Retrospective case control study of children with 'congenital' facial palsy. SETTING Two tertiary referral centres for patients with facial palsy. SUBJECTS 61 children with established facial palsy. MAIN OUTCOME MEASURES Odds ratios of recognised factors for birth injury: maternal primiparity, high birth weight, and the use of obstetric forceps at delivery. RESULTS 13.2% of those studied had forceps assisted delivery compared to 10.2% in the normal population (odds ratio 1.34; 95% confidence intervals 0.61 to 2.97) 39.6% were born to primiparae compared to a national rate of 36.7% (1.13; 0.65 to 1.96) and only 18.9% weighed more than 3500 g at birth (0.37; 0.19 to 0.74). CONCLUSIONS There is no association between the development of permanent 'congenital' facial palsy and recognised risk factors for birth injury. These data suggest an intrauterine rather than a traumatic aetiology.