[Prenatal surveillance and determinants of prenatal follow-up in the Monastir health district].

In Tunisia a survey was conducted of 1190 women who delivered at the maternity ward of the Fattouma Bourguiba University Hospital Center in Monastir during September 1988 to August 1989 to evaluate in an Arab-Moslem context the coverage rate of prenatal care and to identify the determinants of correct prenatal follow-up among users of the central maternity ward. 45.8% of the women received adequate prenatal care (i.e. 4 prenatal visits). 14.4% received no prenatal care. The frequency of adequate prenatal care decreased with age (51.78% for 15-24 years 45.29% for 25-34 years and 35.51% for 35 and over; relative risk [RR] = 1.34). Based on occupation mothers who did not work received the least amount of prenatal care (40.47% vs. 55.63% for moderate profession and 51.76% for superior profession; RR = 1.36). Women who received the least amount of prenatal care were illiterate women (39.89% vs. 53.18% for secondary education and 67.69% for higher education; RR = 1.86). Women whose last pregnancy had a poor outcome (fetal death or miscarriage) were more likely to receive adequate prenatal care than those whose last pregnancy had a good outcome (54.7% vs. 33.6%; RR = 1.47). Women who experienced a medical condition during pregnancy were more likely to receive adequate prenatal care than those who had no such problem (53.7% vs. 45.2%). Primiparous women were more likely to receive adequate prenatal care than multiparous women (55.7% vs. 38.7% for parity 2-4 and 21.7% for parity >5; RR = 1.77). The influence of parity continued even when the researchers controlled for age (p < 0.0003).