Shoklo Malaria Research Unit, Tak, Thailand.
BMC Pregnancy Childbirth. 2011 Jun 17;11:45. doi: 10.1186/1471-2393-11-45.
Maternal and infant health has been associated with maternal education level, which is highly associated with literacy. We aimed at estimating literacy rates among reproductive age women attending antenatal clinics in camps for refugees and in migrant clinics in Tak province, north-western Thailand, to determine whether illiteracy had an impact on birth outcomes.
Three reading assessments were conducted using an identical method each time, in 1995-97, 2003 and 2008. Midwives chose at random one of four pre-set sentences. Each woman was asked to read aloud and scoring was based on a "pass/fail" system. Pregnancy outcomes were compared with maternal literacy rate.
Overall, 47% (1149/2424) of women were able to read. A significant improvement was observed among migrant (34% in 2003 vs. 46% in 2008, p = 0.01), but not refugee (47% in 1995-97, 49% in 2003, and 51% in 2008) women. Literate women were significantly more likely to be of non-Karen ethnicity, primigravidae, non-smokers, to remain free from malaria during pregnancy and to deliver in a health clinic. Significant improvements in pregnancy outcome (reductions in premature births, low birth weight newborns and neonatal death) between 1995-97 and 2003 were unrelated to literacy.
Significant reductions in poor pregnancy outcome over time have not been driven by changes in literacy rates, which have remained low. Access to early diagnosis and treatment of malaria in this population, and delivery with skilled birth attendants, despite ongoing low literacy, appears to have played a significant role.
母婴健康与母亲的受教育程度有关，而受教育程度又与识字率密切相关。我们旨在评估在泰国西北部的难民营和移民诊所中参加产前检查的育龄妇女的识字率，以确定文盲是否对生育结果产生影响。
在 1995-97 年、2003 年和 2008 年期间，使用相同的方法进行了三次阅读评估。助产士随机选择四个预设句子之一。每个妇女都被要求大声朗读，并根据“通过/失败”系统进行评分。将妊娠结局与母亲的识字率进行比较。
总体而言，47%（2424 名中的 1149 名）的妇女能够阅读。在移民中观察到显著的改善（2003 年的 34%比 2008 年的 46%，p=0.01），但在难民中没有观察到（1995-97 年的 47%，2003 年的 49%，2008 年的 51%）。识字的妇女更有可能是非克伦族、初产妇、不吸烟者、在怀孕期间免受疟疾的影响，并在诊所分娩。1995-97 年和 2003 年之间妊娠结局的显著改善（早产、低出生体重新生儿和新生儿死亡的减少）与识字率无关。
尽管识字率仍然很低，但随着时间的推移，不良妊娠结局的显著减少并不是由识字率的变化驱动的。在这个人群中，尽管识字率持续较低，但能够获得疟疾的早期诊断和治疗，以及由熟练的分娩助手进行分娩，似乎发挥了重要作用。
