背景與目的
根據勞動部勞工保險局統計，近五年平均約14萬名女性勞工生育。為使女性勞工健康無虞，政府頒布有《女性勞工母性健康保護實施辦法》，內容包含規定雇主對母性健康危害採取保護措施及風險評估並依情況進行配工。法規施行至今已逾三年，本研究目的為分析臺灣女性勞工於母性健康保護法規實施前後之妊娠結果變化情形。
材料與方法
本研究採用衛生福利部衛生福利資料科學中心之健保承保檔及出生通報檔，分析2007-2016年數據比較法規介入前後的差異，統計資料以次數分配(百分比)呈現者使用卡方檢定，以平均數±標準差呈現者使用雙樣本t檢定，以評估其差異。妊娠結果採邏輯式迴歸分析，並分別依下列數據進行分析：(1)全臺灣數據；(2)主要科學園區及工業區坐落的六大都市數據；(3)法規介入前後皆有生育族群之數據。分析結果變項包括：死產、早產、極度早產、低出生體重、非常低出生體重、第一及第五分鐘Apgar Score低於7分、先天性缺損及妊娠與分娩合併症。
研究結果
研究期間女性勞工出生通報檔數據共計1,292,146筆進行分析，比較法規介入前後之妊娠結果，包括胎次、具危險因子、早產、極度早產、低出生體重、極低出生體重、第一及第五分鐘Apgar Score低於7分及先天性缺陷等，分布之差異達統計顯著。邏輯式迴歸分析顯示法規介入前後皆有生育族群之妊娠結果於死產(相對危險性0.23，95%信賴區間:0.21-0.25)、早產(0.74，0.70-0.78)、極度早產(0.27，0.24-0.30)、低出生體重(0.66，0.63-0.70)、非常低出生體重(0.32，0.29-0.35)、第一及分鐘Apgar Score低於7分(0.36，0.34-0.39)、第五分鐘Apgar Score低於7分(0.26，0.24-0.29)、先天性缺損(0.43，0.36-0.50)及妊娠與分娩合併症(0.79，0.75-0.82)之風險對比值在法規介入後皆顯著降低。
結論
本研究結果顯示母性健康保護法規介入後妊娠結果有正向效應。

Background and objective: In the recent five years, an average of 140 thousand female laborers had given birth each year. To promote the health and safety of all female laborers, the MOL implemented regulation on maternity protection on January 1, 2015. The regulation has currently been implemented for more than three years, and this study aims to assess the changes in pregnancy outcomes after the implementation of the regulations for female laborers in Taiwan.
Methods: This study employed the Registry for Beneficiaries and Birth Certificate Application databases obtained from the Health and Welfare Data Science Center, Ministry of Health and Welfare. Data from year 2007 to 2016 were used. We evaluated differences in the frequency distribution (in %) of categorical variables using the chi-square test. Differences in continuous variables are presented as mean ± standard deviation using the two-sample t-test. We then assessed birth outcomes using logistic regression. Changes in the following populations were analyzed: (1) all of Taiwan, (2) the six cities where major science parks and industrial areas were located, and (3) women with at least one birth each before and after the implementation of the regulations.
Results: A total of 1,292,146 births given by female laborers were identified during the study period. The differences between before and after implementation of the regulations reached statistical significance in age, parity, maternal risk factors, preterm birth, extremely preterm birth, low birth weight, very low birth weight, 1- and 5-minute Apgar Scores less than 7, and birth defects. In workers who had given births both before and after the implementation of the regulations, the first birth after the implementation had lower risks of for stillbirths (odds ratio=0.23, 95% confidence interval: 0.21-0.25), preterm births (0.74, 0.70-0.78), extremely preterm births (0.27, 0.24-0.30), low birth weight (0.66, 0.63-0.70), very low birth weight (0.32, 0.29-0.35), 1--minute Apgar Scores less than 7 (0.36, 0.34-0.39), 5-minute Apgar Scores less than 7 (0.26, 0.24-0.29), birth defects (0.43, 0.36-0.50), and labor and delivery complications (0.79, 0.75-0.82) as compared to the last birth before the implementation.
Conclusion: These results showed that the maternal protection regulations in Taiwan had positive effects on birth outcomes in female laborers.

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