A pregnant woman in Brazil symbolizes improving perinatal health.

Perinatal Health Check: How Brazil Is Shaping Healthier Births

Mira Elwood in Health & Wellness June 2025 • 5 min read.

"An in-depth look into the factors impacting perinatal outcomes in São Luís, Brazil, and what it reveals about global maternal health."

Ensuring the well-being of mothers and their newborns is a global priority, with countless studies and initiatives aimed at improving perinatal health. Temporal analysis, which involves tracking health indicators over time, is an essential tool for understanding the effectiveness of these efforts. By examining trends in maternal and child health, researchers can identify areas of progress, detect emerging challenges, and fine-tune interventions to achieve the best possible outcomes.

In Brazil, researchers have been closely monitoring perinatal health indicators through population-based cohort studies. These studies, which follow groups of individuals over extended periods, provide valuable insights into the factors that influence maternal and child health. By comparing data from different cohorts, researchers can assess the impact of socioeconomic changes, healthcare advancements, and public health policies on perinatal outcomes.

One such study, conducted in São Luís, Maranhão State, Brazil, has shed light on the evolving landscape of perinatal health in this region. By comparing two birth cohorts from 1997/1998 and 2010, researchers have uncovered significant changes in maternal and child health indicators, offering valuable lessons for improving perinatal care in Brazil and beyond.

What Factors are Impacting Perinatal Health in São Luís?

A pregnant woman in Brazil symbolizes improving perinatal health.

The study in São Luís compared data from 2,493 live births in 1997/1998 with 5,166 live births in 2010. The research team analyzed a wide range of factors, including socioeconomic status, maternal characteristics, access to healthcare, and perinatal outcomes. This thorough approach allowed them to gain a holistic understanding of the changes occurring in perinatal health over time.

The study revealed a mixed bag of results. While some key indicators, such as low birth weight (LBW) and preterm birth (PTB) rates, remained relatively stable, there were notable improvements in other areas. These are the details:

Socioeconomic Improvements: The study found that maternal schooling increased, and there was a decrease in the percentage of single mothers and teenage deliveries. These positive changes suggest improved social support and access to education for women in São Luís.
Better Prenatal Care: Prenatal care coverage increased significantly, with more women receiving prenatal care in the first trimester. Early and consistent prenatal care is crucial for identifying and managing potential complications during pregnancy.
Decline in IUGR: The rate of intrauterine growth restriction (IUGR), a condition in which a baby doesn't grow to its normal weight during pregnancy, decreased significantly. This suggests improvements in maternal health and nutrition during pregnancy.
Lower Mortality Rates: Both infant mortality rate (IMR) and perinatal mortality rate (PMR) dropped sharply, indicating progress in saving the lives of newborns and infants.
Increased Cesarean Rates: On the downside, the cesarean rate increased, raising concerns about the potential overuse of this surgical procedure.

Despite the encouraging improvements in socioeconomic factors, prenatal care, IUGR, and mortality rates, the stability of LBW and PTB rates is a cause for concern. These findings suggest that additional interventions may be needed to address these persistent challenges. The increase in cesarean rates also warrants attention, as it could potentially lead to adverse health outcomes for mothers and babies.

What Do These Trends Tell Us About Maternal Health?

The study in São Luís provides valuable insights into the complexities of improving perinatal health. While socioeconomic improvements and increased access to prenatal care are essential, they may not be sufficient to address all the challenges facing mothers and newborns. Factors such as LBW and PTB rates may require more targeted interventions, such as nutritional support, smoking cessation programs, and improved management of chronic health conditions during pregnancy. Continued monitoring and evaluation are crucial for ensuring that interventions are effective and tailored to the specific needs of the population.

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This article is based on research published under:

DOI-LINK: 10.1590/0102-311x00100314, Alternate LINK

Title: Changes In Perinatal Health In Two Birth Cohorts (1997/1998 And 2010) In São Luís, Maranhão State, Brazil

Subject: Public Health, Environmental and Occupational Health

Journal: Cadernos de Saúde Pública

Publisher: FapUNIFESP (SciELO)

Authors: Antônio Augusto Moura Da Silva, Rosângela Fernandes Lucena Batista, Vanda Maria Ferreira Simões, Erika Barbara Abreu Fonseca Thomaz, Cecília Cláudia Costa Ribeiro, Fernando Lamy Filho, Zeni Carvalho Lamy, Maria Teresa Seabra Soares De Britto E Alves, Flávia Helen Furtado Loureiro, Viviane Cunha Cardoso, Heloisa Bettiol, Marco Antonio Barbieri

Published: 2015-07-01

Everything You Need To Know

What are the key indicators of perinatal health that were studied in São Luís, Brazil?

The study in São Luís examined a wide array of indicators to understand the changes in perinatal health. These included socioeconomic status, maternal characteristics, access to healthcare, and perinatal outcomes. Specific perinatal outcomes analyzed were low birth weight (LBW), preterm birth (PTB) rates, intrauterine growth restriction (IUGR), infant mortality rate (IMR), perinatal mortality rate (PMR), and cesarean rates.

How did socioeconomic changes impact maternal health in São Luís?

The study revealed several positive socioeconomic changes, including an increase in maternal schooling, a decrease in the percentage of single mothers, and fewer teenage deliveries. These improvements suggest that enhanced social support and educational opportunities for women in São Luís contributed to better maternal health outcomes.

What specific healthcare improvements were observed in São Luís, and what impact did they have?

Significant improvements were seen in prenatal care coverage, with more women receiving prenatal care in the first trimester. This early and consistent prenatal care is crucial for identifying and managing potential complications during pregnancy. Furthermore, there was a decline in intrauterine growth restriction (IUGR), which indicated improvements in maternal health and nutrition during pregnancy. Both infant mortality rate (IMR) and perinatal mortality rate (PMR) dropped sharply, showing progress in saving the lives of newborns and infants.

Why is the stability of low birth weight (LBW) and preterm birth (PTB) rates concerning despite other positive trends in São Luís?

The persistence of stable LBW and PTB rates, despite improvements in other areas like socioeconomic factors and prenatal care, suggests that more targeted interventions are needed. These rates may require specific strategies such as nutritional support, smoking cessation programs, and better management of chronic health conditions during pregnancy. This also highlights the complex nature of perinatal health, where overall improvements do not always translate to consistent progress across all indicators.

What are the implications of the increase in cesarean rates in the São Luís study, and what does this suggest?

The increase in cesarean rates in São Luís raises concerns about the potential overuse of this surgical procedure. While cesareans can be life-saving in certain situations, an increased rate could lead to adverse health outcomes for both mothers and babies. This trend suggests a need for careful evaluation and monitoring of cesarean practices to ensure they are medically justified and do not contribute to unnecessary risks. The study indicates that alongside socioeconomic improvements and prenatal care, there is a need for more nuanced interventions to address LBW and PTB, which calls for ongoing monitoring and evaluation of healthcare practices.