Maternal and child health in a marginalized community along the Thai-Myanmar border

The objective of this study was to conduct a cross-sectional evaluation of pregnancy indicators, child growth failure, and the effect of antenatal care on birth outcomes in a marginalized community under the care of a health center in Suan Phung District, Ratchaburi Province. Health and socioeconomic data about children born in 2007 and their parents were obtained from the sub-district health center and district hospital were collected and analyzed by univariate and multivariate methods. Most of the residents in the study were Karen ethnic origin. Data was available for 152 children, of which 136 met study inclusion criteria. Health outcomes of the study population significantly different from the general Thai population included higher average parity (2.53 ± 1.99 vs 1.735; p<0.001), lower average birth weight (2,876.05 ± 399.48 grams vs 3,200 grams, p<0.001), and lower average height-for-age and weight-for-age (p<0.001). The prevalences of stunting, underweight and wasting were higher than the general Thai population (p<0.001). Having fewer than 4 antenatal care (ANC) visits was associated with low birth weight (unadjusted OR 4.88, 95% CI 1.13-21.05; adjusted OR 5.77, 95% CI 1.27- 26.30).