Pregnancy Rates Among Myanmar Migrant Workers Who Pursue Employment in Thailand

Abstract

Urine pregnancy diagnostic test is easily available. It is a requirement of the screening program for Myanmar workers who pursue employment in Thailand. Only a few studies have estimated population pregnancy rates using objective and laboratory‐based criteria. Here, the authors performed a study on laboratory‐measured pregnancy rates among Myanmar workers who pursue employment in Thailand from an experience in a tertiary hospital in Thailand. The data from medical records of the female Myanmar migrant workers who got a diagnostic urine pregnancy test at Division of Laboratory Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from July 2004 to June 2005 were reviewed. A total of 263 medical records were reviewed in this study. There were 17 positive cases of the overall 263. The diagnostic test results were negative in 246 cases (93.5%) and positive in 17 (6.5%). Screening for the urine pregnancy among these migrant workers can help decrease the improper antenatal care.

Urine pregnancy diagnostic test is easily available. Based on simple basic immunological principle, ^1–3 many urine pregnancy diagnostic tests were produced. ⁴ Due to comfort in use and inexpensive cost, it is widely used nowadays. Urine pregnancy is a requirement of the screening program for Thai workers seeking overseas employment. It is also a requirement of the screening program for Indochina migrants who immigrate into Thailand for work.

Only a few studies have estimated population pregnancy rates using objective and laboratory‐based criteria. ⁵ Study on the demographic data of the laboratory screenees, especially for the marital status, can provide the answer to the query that if the pregnancy test result can be a good predictive factor of pregnancy. ⁵ Of interest, the epidemiology of pregnancy rate in migrants has never been precisely determined. The purpose of this study was to determine the rate of pregnancy among the Myanmar migrants who pursue employment in Thailand.

Here, the authors performed a study on laboratory‐measured pregnancy rates among this population from an experience in a tertiary hospital in Thailand. The results from this study can be good information in both medical and social aspects.

Materials and methods

The data from medical records of the Myanmar migrant workers who pursue employment in Thailand and got a diagnostic urine pregnancy test at Division of Laboratory Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from July 2004 to June 2005 were reviewed. The laboratory setting is the largest of the Thai Red Cross Society, with accreditation for ISO 15189 standard. The urine pregnancy test mentioned in this study is a one‐step pregnancy test and a rapid one‐step membrane test for detection of human chorionic gonadotropin in urine (One‐Step hCG Pregnancy Test; Search Tech Co. Ltd, Bangkok, Thailand). The accuracy of the test is about 99%. In this work, any patients with undetermined results and presenting with weakly positive results are reanalyzed using the second urine samples collected at 2 to 4 weeks after the first samples. Results in medical records were reviewed and collected. Records that had no complete data were excluded. Descriptive statistical analysis, including frequency and percentage calculations, was carried out on the data where it was appropriate.

Results

A total of 263 medical records were reviewed in this study. Age distribution of the sample population is shown in Table 1. Marital status of the sample population is shown in Table 2. There were 17 positive cases of the overall 263. The diagnostic test results were negative in 246 cases (93.5%) and positive in 17 (6.5%) (Table 3).

Discussion

Urine pregnancy test is frequently used in medicine due to its convenience and effectiveness. The common indication for the test is missed menstruation. However, it is presently included as a required screening test for the workers who pursue overseas employment according to Thai Labor Act. In addition, the migrant workers who pursue employment in Thailand are also requested to take the test. The administrative purpose of the screening program for the migrant workers is to decrease the poor management of these workers. Before the setting of the program, most migrant workers who got pregnant were usually denied additional work from their bosses or referred back to local services in Myanmar. Some cases of illegal abortions also occurred.

In this study, most of the results of the urine pregnancy tests were negative. Considering the positive testing applicants, all did not know that they were pregnant and all got additional proper antenatal care from the hospital. Most of the pregnant subjects were single and aged 21 to 35 years. Comparing the data from Thai residents seeking overseas employment, the similar pregnancy rate (for Thai residents, 5.7%) and pattern of urine pregnancy testing can be observed. ⁶

Generally, Myanmar migrants who immigrate into Thailand for work can be considered as an underprivileged population. They usually lack proper health care. Luckily, the health checkup program for these workers has recently been set according to the National Labor Act. According to the Act, the migrants who have positive urine pregnancy test will get additional proper antenatal care. According to this study, the pregnancy could be detected in 6.5% of migrant workers, and the proper management can be given. It also means that these subjects are not poorly managed for their pregnancy or lack of employment.

Significant ethical and human rights implications are involved in the pregnancy testing of migrant workers. This is a significant international health issue associated with testing programs of this type. No pregnancy testing or illegal pregnancy testing of female migrant workers, both on application and regularly during their employment, is commonly associated with deportation, lack of employment, or denial of admission. Setting a legal program of urine pregnancy testing can decrease these problems. In addition, screening for the urine pregnancy among these migrant workers can help decrease the improper antenatal care. The results from this study can serve as basic data for other continuing studies. Additional studies as multicenter studies are recommended.

We thank the medical personnel of the Division of Laboratory Medicine, King Chulalongkorn Memorial Hospital for their cooperation in performing this study.

Declaration of interests

The authors state that they have no conflicts of interest.

References