Search

Background Preterm births increase mortality and morbidity during childhood and later life, which is closely associated with poverty and the quality of prenatal care. Therefore, income redistribution and poverty reduction initiatives may be valuable in preventing this outcome. We assessed whether receipt of the Brazilian conditional cash transfer programme - Bolsa Familia Programme, the largest in the world - reduces the occurrence of preterm births and explored how this association differs according to prenatal care and quality of Bolsa Familia Programme management.Methods A retrospective cohort study was performed involving live singleton births from 2012–2015 to mothers registered in the 100 Million Brazilian Cohort from 2004–2015, considering a deterministic linkage with the Bolsa Familia Programme payroll datasets and similarity linkage with the Brazilian Live Birth Information System. The exposed group consisted of newborns to mothers who received Bolsa Familia from conception to delivery. Our outcomes were infants born with a gestational age Results 1,031,053 infants were analyzed; 65.9% of the mothers were beneficiaries. Bolsa Familia Programme was not associated with all sets of preterm births, moderate-to-late, and severe preterm births, but was associated with a reduction in extreme preterm births (weighted OR: 0.69; 95%CI: 0.63–0.76). This reduction can also be observed among mothers receiving adequate prenatal care (weighted OR: 0.66; 95%CI: 0.59–0.74) and living in better Bolsa Familia management municipalities (weighted OR: 0.56; 95%CI: 0.43–0.74).Conclusions An income transfer programme for pregnant women of low-socioeconomic status, conditional to attending prenatal care appointments, has been associated with a reduction in extremely preterm births. These programmes could be essential in achieving Sustainable Development Goals.