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Background: There is a lack of evidence for the effectiveness of health promotion interventions during pregnancy and early childhood. This study aims to investigate the effectiveness of the Salut Programme, a universal health promotion intervention in a Swedish County, compared to care as usual.

Methods: A register-based retrospective observational study design is used with respect to both exposures and outcomes. Outcomes of interest during pregnancy, delivery and the child’s first three years of life included: direct indications of health risks, such as birth weight, Apgar scores, hospitalization, delivery; and indicators of poor health, such as child’s and mother’s hospital visits, and parents’ number of paid days for care of sick child. We compared outcomes of interest for both parents and children during pre- (children born 2002-2004) and post- (born 2006-2008) measure periods for the intervention (n = 1891 children, n = 1599 mothers), and non-intervention groups (n = 12723 children, n = 10544 mothers). Our analysis strategy combined difference-in-difference estimation with matching. A complementary analysis was carried out on the longitudinal subsample of women who gave birth in both the pre- and post- measure periods.

Results: No significant changes were found in the difference-in-difference analysis. A few significant changes were found between intervention and non-intervention groups in the longitudinal analysis; for the Apgar scores 1 and 5 minutes (p < 0.001), and hospitalization during the first three years after birth for mothers (p = 0.002).

Conclusions: Adding the Salut Programme to the care as usual provided minor effects on children’s and mothers’ health, for the outcomes used in this study. However, the health outcomes may impact child public health in the long-time perspective.

Key message: In this study of the effectiveness of a universal health promotion intervention, the Salut Programme, some positive impact was found on child and maternal health outcomes