(1119) Omphalocele and gastroschisis trends among states with vs without 20-week abortion bans from 2012-2018

Prior to recent legislature changes, many states enacted 20-week abortion bans. As related laws are implemented, understanding associated impacts may help guide future care. Gastroschisis and omphalocele diagnoses are often diagnosed at 20-week anatomy ultrasounds. Omphalocele is more often associated with other anomalies and carries a greater mortality rate compared to gastroschisis. We sought to examine trends in rates of gastroschisis and omphalocele diagnoses between states with and without 20-week abortion bans in the US during 2012-2018. 

Study Design:

A retrospective cohort study of all deliveries in the US between 2012-2018 using linked vital statistics data. Data analysis stratified gastroschisis vs omphalocele. States were categorized as those with or without a 20-week abortion ban. States that enacted bans later than 2014 were included in the no-ban group. We used Cochrane-Armitage tests to assess trends and multivariable logistic regressions to control for maternal age, race, education, insurance, and ≥ 5 prenatal visits.

Results:

Our cohort consisted of 17,444,271 deliveries in states without 20-week abortion bans and 8,763,579 deliveries in states with such bans. Diagnoses of gastroschisis significantly decreased over time in both states with and without 20-week abortion bans (p=0.0001, p< 0.0001) (Figure 1). In states with bans, omphalocele rates increased significantly over time (p=0.0042) (Table 1). In states without bans, no significant change in rates were shown (p=0.4971).

Conclusion:

Between 2012-2018, omphalocele rates increased significantly in states with 20-week abortion bans, while displaying no significant change in states without bans. Gastroschisis rates decreased significantly in both states with and without abortion bans, with no significant differences between the two groups. As many 20-week abortion bans were enacted near the beginning of the time period of this study, it’s possible that the differences seen are related to these policies, indicating that such legislation may inhibit patient autonomy.