OBJECTIVES: To investigate the effectiveness and cost-effectiveness of the Salut Programme, a universal health promotion intervention in a Swedish County, compared to care-as-usual, during pregnancy, delivery and the child’s first two years of life, from a limited societal perspective. METHODS: A register-based retrospective observational study design is used with respect to both exposures and outcomes. We analysed outcomes during pregnancy, delivery and the child’s first two years of life including birth weight and Apgar scores, information on child’s and mother’s inpatient and outpatient visits, and number of paid days for care of sick child. We simulated an experiment by retrospectively identifying geographical areas within the County where the Salut Programme was implemented in 2006-2007 (intervention group) and areas where Salut was not implemented (non-intervention group). We compared outcomes for parents and children during pre- (children born 2002-2004) and post- (children born 2006-2008) measure periods for the intervention (n=1891 children, n=1599 mothers), and non-intervention groups (n=12,723 children, n=10,544 mothers). Our analysis combined difference-in-difference estimation with matching, and a complementary analysis on the longitudinal subsample of women who gave birth at both the pre- and post- measure periods. A cost-effectiveness analysis compared costs and outcomes of the Salut programme to care-as-usual. RESULTS: No significant changes were found in the difference-in-difference analysis. A few significant changes were found between the intervention and non-intervention groups in the longitudinal analysis for Apgar scores 1 and 5 minutes. The intervention showed a significant reduction in total hospitalization time of 0.5 days per mother (p=0.002). The average annual implementation cost per mother in the intervention group was INT$105 (914 SEK) (828 mothers). This resulted in savings of INT$494 (4303 SEK) per mother. CONCLUSIONS: Adding the Salut Programme to the care as usual provided minor health effects. The Salut programme is cost-saving during the study period.