[Chronological observation of the epidemiological characteristics of perinatal indicators in the Monastir health region (Tunisia) between 1994 and 2008].

In the Tunisian healthcare system, the mother-child pair is a key target of the national perinatal program established in 1990. The purpose of this study is to define the epidemiological profile and to study the chronological tendencies of the main perinatal care indicators in the region of Monastir. The paper is based on a population study involving all parturients who gave birth in Monastir public maternities over a period of 15 years (1 January 1994 to 31 December 2008). Data were drawn from the register of births of all public maternities located in the region. The study examined 121,046 parturients. The mean age of parturients was 28.8 ± 5.5 years. 17.2% of parturients were aged 35 and over. Two thirds of deliveries were performed in the 2nd and 3rd level care maternities. Over the course of the fifteen years, absent prenatal care decreased significantly, from 11% in 1994 to 1% in 2008 (p<0.001). The percentage of parturients aged 35 and over increased significantly, from 14% in 1994 to 18% in 2008 (p< 0.001). Prematurity also increased significantly, from 4.2% in 1994 to 7% in 2008. These results are a reflection of the demographic and social transition of the country. The Tunisian healthcare system will need to show greater vigilance and to promote a greater focus on prenatal care quality.