Association of State Gestational Age Limit Abortion Laws With Infant Mortality.
Association of State Gestational Age Limit Abortion Laws With Infant Mortality.
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DOI：
10.1016/j.amepre.2021.05.022
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发表时间：
2021-12
影响因子：
5.5
通讯作者：
Wallace ME
中科院分区：
文献类型：
--
作者：
Karletsos D;Stoecker C;Vilda D;Theall KP;Wallace ME
越来越多的州立法机构通过了限制特定胎龄后获得堕胎护理的法律（胎龄限制法）。这些法律对孕产妇和儿童人口健康结果和不平等的影响尚不清楚。本研究的目的是确定实施胎龄限制法律的州是否会经历婴儿死亡率的后续变化。使用来自国家卫生统计中心的美国人口数据链接婴儿死亡档案（2005-2017），使用多变量线性回归估计差异中的差异模型，以比较具有胎龄限制法律的州与没有此类法律的州的婴儿死亡率（全因和特定原因率）的趋势。按母亲种族/民族分层的模型探讨了法律影响中的种族异质性。2020年数据分析。这项研究包括在2005年至2017年期间颁布怀孕年龄限制堕胎法的州出生的16，232，133名新生儿和在2005年至2017年期间没有颁布怀孕年龄限制堕胎法的州出生的36，472，309名新生儿。在差异中差异分析中，胎龄限制法律与每1,000例活产婴儿中0.23例额外婴儿死亡相关（95%CI =0.09，0.37，p<0.01）。在原因特异性分析中，胎龄限制法律与每1，000例活产婴儿中0.10例因先天性异常而导致的婴儿死亡相关（95% CI=0.03，0.17，p=0.01）。在按母亲种族/民族分层的模型中，胎龄限制法律与婴儿死亡率之间的关联没有统计学意义。根据2005年至2017年的数据，颁布胎龄限制堕胎法的州随后经历了婴儿死亡率的上升。
A growing number of state legislatures have passed laws that restrict access to abortion care after a specified gestational age (gestational age limit laws). The impact of these laws on maternal and child population health outcomes and inequities is unknown. The objective of this study is to determine whether states that implement gestational age limit laws experience subsequent changes in rates of infant mortality. Using U.S. population-based data from the National Center for Health Statistics Linked Infant Birth-Death Files (2005–2017), difference-in-differences models were estimated using multivariable linear regressions to compare trends in infant mortality (all-cause and cause-specific rates) in states with gestational age limit laws relative to states without such laws. Models stratified by maternal racial/ethnic group explored racial heterogeneity in the law’s impact. Data were analyzed in 2020. This study included 16,232,133 births in states that enacted a gestation age limit abortion law and 36,472,309 births in states that did not from 2005 to 2017. In difference-in-difference analyses, gestational age limit laws were associated with 0.23 excess infant deaths per 1,000 live births (95% CI=0.09, 0.37, p<0.01). In cause-specific analyses, gestational age limit laws were associated with 0.10 additional infant deaths due to congenital anomalies per 1,000 live births (95% CI=0.03, 0.17, p=0.01). Associations between gestational age limit laws and infant mortality in models stratified by maternal racial/ethnic group were not statistically significant. Based on data from 2005 to 2017, states that enacted gestational age limit abortion laws subsequently experienced increased infant mortality rates.