Perinatal care in Portugal: effects of 15 years of a regionalized system

Acta Paediatr. 2006 Nov;95(11):1349-52. doi: 10.1080/08035250600615135.


Aim: To share information on the organization of perinatal care in Portugal.

Methods: Data were derived from the Programme of the National Committee for Mother and Child Health 1989, National Institute for Statistics, and Eurostat.

Results: In 1989, perinatal care in Portugal was reformed: the closure was proposed of maternity units with less than 1500 deliveries per year; hospitals were classified as level I (no deliveries), II (low-risk deliveries, intermediate care units) or III (high-risk deliveries, intensive care units), and functional coordinating units responsible for liaison between local health centres and hospitals were established. A nationwide system of neonatal transport began in 1987, and in 1990 postgraduate courses on neonatology were initiated. With this reform, in-hospital deliveries increased from 74% before the reform to 99% after. Maternal death rate decreased from 9.2/100,000 deliveries in 1989 to 5.3 in 2003 and, in the same period, the perinatal mortality rate decreased from 16.4 to 6.6/1000 (live births + stillborn with > or = 22 wk gestational age), the neonatal mortality rate decreased from 8.1 to 2.7/1000 live births, and the infant mortality rate from 12.2/1000 live births to 4/1000.

Conclusion: Regionalization of perinatal care and neonatal transport are key factors for a successful perinatal health system.

MeSH terms

  • Female
  • Fetal Mortality / trends*
  • Health Care Reform
  • Humans
  • Infant Mortality / trends*
  • Infant, Newborn
  • Maternal Mortality / trends*
  • National Health Programs / organization & administration*
  • Neonatology / education
  • Neonatology / organization & administration*
  • Perinatal Care / organization & administration*
  • Portugal / epidemiology
  • Pregnancy
  • Regional Health Planning
  • Regional Medical Programs / organization & administration*