A pregnant woman in São Luís symbolizes improved maternal health.

Perinatal Health Check: How Brazil Improved Infant Mortality but Still Faces Challenges

Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"Discover the progress and persistent issues in perinatal health in São Luís, Brazil, including stable low birth weight rates and the rise of C-sections."

Tracking the well-being of mothers and their babies during the critical period around birth, known as perinatal health, provides vital insights into the effectiveness of healthcare systems and broader societal progress. By studying key indicators like infant mortality rates, low birth weight, and access to prenatal care, researchers and policymakers can identify areas of success and pinpoint where improvements are needed. These insights guide the development of targeted interventions and policies designed to promote healthier outcomes for both mothers and their children.

In Brazil, a country marked by significant regional disparities, understanding these trends is particularly crucial. While major cities have seen considerable advancements in healthcare infrastructure and socioeconomic conditions, many smaller towns and rural areas still grapple with significant challenges. By comparing perinatal health indicators across different regions and time periods, we gain a more nuanced understanding of the factors that contribute to positive outcomes and the obstacles that must be overcome to ensure the health and well-being of all Brazilian mothers and infants.

A recent study focused on São Luís, the capital of Maranhão, one of Brazil's poorest states, offers valuable insights into this complex landscape. By comparing data from two birth cohorts—one from 1997/1998 and another from 2010—researchers were able to assess changes in key perinatal health indicators and identify areas of progress and persistent challenges. This analysis sheds light on the impact of socioeconomic shifts, healthcare interventions, and other factors on the health of mothers and their newborns in this region.

Key Findings: Progress and Persistent Issues

A pregnant woman in São Luís symbolizes improved maternal health.

The study compared two groups of births in São Luís: 2,493 infants born in 1997/1998 and 5,166 in 2010. Here’s what they discovered:

Some indicators showed positive trends:

Improved Socioeconomic Conditions: More women had completed higher levels of schooling.
Better Prenatal Care: A greater percentage of women received prenatal care, and they started earlier in their pregnancies.
Reduced Teenage Pregnancies: There were fewer births to mothers under 20 years old.
Decreased Fetal Growth Restriction: Fewer babies experienced restricted growth in the womb (intrauterine growth restriction, or IUGR).
Lower Mortality Rates: Both perinatal mortality rate (deaths shortly before or after birth) and infant mortality rate (deaths within the first year of life) decreased significantly.

However, not all the news was good:

Looking Ahead: Addressing the Remaining Challenges

While São Luís has made notable strides in improving perinatal health, the study highlights the need to address persistent challenges. Maintaining focus on equitable access to quality prenatal care, understanding the factors behind stable LBW and PTB rates, and addressing the rising cesarean section rate are crucial steps for further progress. By continuing to monitor these trends and implement targeted interventions, São Luís can ensure healthier outcomes for mothers and their babies, setting an example for other regions in Brazil and beyond.

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Everything You Need To Know

What is perinatal health and why is it important to study in Brazil?

Perinatal health focuses on the well-being of mothers and their babies around the time of birth. Studying this in Brazil is crucial because it reveals the effectiveness of healthcare systems and societal progress, especially given the country's regional disparities. Monitoring indicators like infant mortality rates, low birth weight, and access to prenatal care allows for targeted interventions to improve outcomes for mothers and their children. Understanding these trends in places like São Luís helps address challenges and promote healthier outcomes nationwide.

How did socioeconomic changes impact perinatal health in São Luís between 1997/1998 and 2010?

The study in São Luís showed that socioeconomic improvements, such as more women completing higher levels of schooling, positively impacted perinatal health. These changes correlated with better prenatal care, fewer teenage pregnancies, and a decrease in fetal growth restriction. These improvements ultimately led to lower perinatal and infant mortality rates, indicating that socioeconomic advancements play a key role in improving maternal and infant health.

What specific improvements were seen in São Luís related to perinatal health during the study period?

The study in São Luís revealed several positive trends. More women received prenatal care earlier in their pregnancies. There were fewer teenage pregnancies, and fetal growth restriction decreased. Critically, both the perinatal mortality rate and the infant mortality rate significantly decreased. These improvements suggest that targeted interventions and better access to care had a positive impact on outcomes for mothers and newborns.

Despite improvements, what persistent challenges remain in perinatal health in São Luís?

Even with the progress made, São Luís still faces challenges. Maintaining equitable access to high-quality prenatal care is crucial. The study highlights the need to understand factors contributing to stable low birth weight (LBW) and preterm birth (PTB) rates, alongside addressing the rising rate of cesarean sections. These areas require further attention and intervention to ensure continued improvement in perinatal health.

How can São Luís continue to improve perinatal health outcomes for mothers and babies?

São Luís can continue to improve outcomes by focusing on several key areas. Maintaining and improving equitable access to quality prenatal care is crucial. It's also essential to investigate the reasons behind the stable rates of low birth weight (LBW) and preterm birth (PTB). Addressing the increasing cesarean section rate is another priority. By monitoring these trends and implementing targeted interventions, São Luís can build on its successes and serve as a model for other regions in Brazil and beyond.