| S3Q08E | Sex of fifth child | |__| |
| S3Q08F | Sex of sixth child | |__| |
| S3Q09 | Number of new-born whose weigth was less than 2500 g | |__||__| |
| S3Q10 | Number of new-born whose weigth was greater than 4000 g | |__||__| |
| Monitoring of the current pregnancy (from which the newborn included) | ||
| S3Q11 | LMP (last menstrual period) | |__||__|/|__||__|/|__||__||__||__| |
| S3Q12 | Ga (gestational age) (in WA) | |__||__| |
| S3Q13 | Interbirth space |
|
| S3Q14 | Date of start of ANC | |__||__|/|__||__|/|__||__||__||__| |
| S3Q15 | Term |
|
| S3Q16 | Number of ANC | |__||__| |
| S3Q17 | Place of ANC | |____________________________________| |
| S3Q18 | Check-ups during pregnancy |
|
| S3Q18A | FBC (level of hemoglobin) |
|
| S3Q18B | Positive serologies | |__| (1 = TPHA/VDRL, 2 = Toxoplasmosis, 3 = Rubella, 4 = AgHbs, 5 = Others (to precise)) |
| S3Q18BA | Details on other positive serologies |
|
| S3Q18C | Fasting capillary blood glucose |
|
| S3Q20 | First trimester echographie | |__| (1 = yes, 2 = No) |
| S3Q20A | Term |
|
| S3Q21 | second trimester echographie | |__| (1 = yes, 2 = No) |
| S3Q21A | Estimated fetal weight (EFW) | |__||__|,|__||__||__| |
| S3Q22 | Pathologies in pregnancy (If None go to S3Q23) | |__| (1 = Malaria, 2 = Hemorrhagic, 3 = Urinary infections, 4 = Genital infection; 5 = hyperemesis gravidarum, 6 = preeclampsia, 7 = Gestational diabetes, 8 = None) |
| S3Q22A | Other pathologies in pregnancy |
|
| S3Q23 | Prophylaxy (1 = yes, 2 = No) | |
| S3Q23A | Intermittent preventive treatment | |__| |
| S3Q23B | Antianaemic | |__| |
| S3Q24 | Nutrition during pregnancy |
|
| S3Q24A | Number of meals before pregnancy | |__||__| |
| S3Q24B | Number of meals during pregnancy | |__||__| |
| S3Q24C | Number of meals added | |__||__| |
| Medical (Except S3Q31,1 = yes, 2 = No) | ||
| S3Q25 | HTN | |__| |