(841) Impact of restricted access to abortion services on prenatal diagnostic genetic testing in Texas

Texas Senate Bill 8 (SB8) went into effect 09/21/2021, effectively banning termination with detected embryonic cardiac activity. Similar restricted access laws are being passed in other states. Our aim was to assess if rates of prenatal diagnostic testing were of significant difference prior to or post SB8 effect date using a population based-cohort in Houston, TX.

Study Design:

This was a retrospective cohort study of a prospectively collected perinatal database from a large academic center comprised of all deliveries since 2011 in two hospitals in Houston, TX. Pregnancies with prenatal care (PNC) started after SB8 went into effect were compared to all pregnancies that delivered during the prior two years. Pregnancy characteristics, PNC data, and rates of diagnostic genetic testing were compared between the groups. The primary outcome was rate of prenatal diagnostic genetic testing (amniocentesis or chorionic villous sampling).

Results:

111 pregnancies with complete data had PNC initiated after SB8 was implemented (data available from 09/21/21-1/31/22), and 7762 had PNC initiated in the two years prior to SB8. Rates of fetal anomalies, abnormal genetic screening, ART, and planned pregnancy were similar between the groups (Table 1). The mean gestational age at the first prenatal visit was higher in the post-SB8 group (18.2 vs 12.6 weeks, p< 0.001). The primary outcome was not statistically different between the two groups, however, 0 of 111 post-SB8 patients had a diagnostic genetic test (compared to 57 of 7762 in the pre-SB8 group).

Conclusion:

The rate of prenatal diagnostic genetic testing was not statistically different after implementation of restrictive termination legislation in Texas. However, no patients with PNC after the restrictive law went into effect had diagnostic genetic testing. The lack of statistical significance is likely due to the recency of SB8 and our sample only representing the first four months post-SB8. While not statistically significant, this preliminary study suggests there may be a decreased rate of diagnostic genetic testing with restricted access to abortion services.