Low birth weight (LBW) remains a major public health concern globally and it is associated with a wide range of both short- and long-term consequences ultimately affecting human capital. Globally, it is estimated that 20 million births a year are LBW. In 2012, the World Health Assembly targeted to reduce 30% of LBW, by 2025, calling attention for a set of policies and cost-effective interventions that could reduce LBW. Portugal represents a country where the incidence of LBW has steadily increased, reaching 9.0% in 2018.
LBW is related with important modifiable maternal psychosocial and behavioural determinants. Such factors as smoking, alcohol consumption, maternal mental health and interpersonal violence during pregnancy are plausible targets for interventions, taking into consideration their frequency and expected attributable fraction. Despite such evidence, there is a lack of studies evaluating the effect on LBW of well-designed perinatal interventions taking a syndemic approach. We aim to intervene on key maternal risk factors – smoking, alcohol consumption, depression and physical abuse – by providing fast-track referral to the relevant established services so that a reduction of the rates of avoidable LBW may be achieved. The secondary outcomes are the reduction or cessation of each specific risk.
A randomized control trial in a sample of Portuguese pregnant women will be implemented at the primary health care level in Lisbon and Porto Metropolitan areas. Approximately 240 functional units nested in 13 groups of primary care centers will be randomized to intervention or control groups.