美国德克萨斯大学奥斯汀分校Kari White团队研究了德克萨斯州2021年禁止早孕堕胎法案与德克萨斯州及周边州机构堕胎数量的关系。2022年11月1日出版的《美国医学会杂志》发表了这一最新研究成果。

德克萨斯州2021年禁止早孕堕胎法案有望证明，在美国最高法院2022年6月推翻罗诉韦德案的裁决后，堕胎模式可能会发生怎样的变化。

为了评估德克萨斯州参议院第8号法案（SB 8）实施后的前6个月内，德克萨斯州居民在怀孕12周及以上时堕胎次数的变化和州外堕胎比例的变化，该法案禁止在检测到胎心活动后堕胎。

对50个德克萨斯州和州外堕胎机构的样本进行回顾性研究，使用间断时间序列分析来评估堕胎次数的变化，并使用泊松回归来评估妊娠12周及以上堕胎的变化。数据包括从2020年9月1日至2022年2月28日的研究期间，德克萨斯州居民中68820例基于机构的堕胎和11287例州外堕胎。暴露因素为实施SB 8后（2021年9月-2022年2月）与实施SB 8前（2020年9月-2021年8月）获得的堕胎护理。

主要结局是实施SB 8后一个月内，德克萨斯州和州外的德克萨斯居民基于机构的堕胎数量与前一个月相比发生的变化。次要结局是，在SB 8实施后的6个月期间，德克萨斯州居民在怀孕12周及以上时获得的州外堕胎比例发生的变化。

2020年9月至2021年8月，德克萨斯州共有55018例堕胎，德克萨斯州居民中有2547例州外堕胎。在SB 8后的6个月内，德克萨斯州有13802例堕胎，德克萨斯州居民有8740例州外堕胎。与SB 8实施前一个月相比，德克萨斯州机构堕胎的数量从5451例显著减少到2169例（减少了3282例；发生率比[IRR]为0.43）。

德克萨斯州居民的州外堕胎数量从222例显著增加到1332例（增加了1110例；IRR为5.38）。2021年9月至2022年2月，德克萨斯州居民在妊娠12周及以上进行的州外堕胎从17.1%（221/1291）增加到31.0%（399/1289）（增加了178例），差异显著。

研究结果表明，在堕胎机构的样本中，德克萨斯州2021禁止早孕堕胎的法律（SB 8）与德克萨斯州机构堕胎记录总数显著相关，与上月相比，堕胎总数显著减少。在SB 8实施后的6个月内，德克萨斯州居民在怀孕12周或以上时进行的州外堕胎比例显著增加。

附：英文原文

Title: Association of Texas’ 2021 Ban on Abortion in Early Pregnancy With the Number of Facility-Based Abortions in Texas and Surrounding States

Author: Kari White, Gracia Sierra, Klaira Lerma, Anitra Beasley, Lisa G. Hofler, Kristina Tocce, Vinita Goyal, Tony Ogburn, Joseph E. Potter, Samuel L. Dickman

Issue&Volume: 2022-11-01

Abstract:

Importance  Texas’ 2021 ban on abortion in early pregnancy may demonstrate how patterns of abortion might change following the US Supreme Court’s June 2022 decision overturning Roe v Wade.

Objective  To assess changes in the number of abortions and changes in the percentage of out-of-state abortions among Texas residents performed at 12 or more weeks of gestation in the first 6 months following implementation of Texas Senate Bill 8 (SB 8), which prohibited abortions after detection of embryonic cardiac activity.

Design, Setting, and Participants  Retrospective study of a sample of 50 Texas and out-of-state abortion facilities using an interrupted time series analysis to assess changes in the number of abortions, and Poisson regression to assess changes in abortions at 12 or more weeks of gestation. Data included 68820 Texas facility–based abortions and 11287 out-of-state abortions among Texas residents during the study period from September 1, 2020, to February 28, 2022.

Exposures  Abortion care obtained after (September 2021–February 2022) vs before (September 2020–August 2021) implementation of SB 8.

Main Outcomes and Measures  Primary outcomes were changes in the number of facility-based abortions for Texas residents, in Texas and out of state, in the month after implementation of SB 8 compared with the month before. The secondary outcome was the change in the percentage of out-of-state abortions among Texas residents obtained at 12 or more weeks of gestation during the 6-month period after the law’s implementation.

Results  Between September 2020 and August 2021, there were 55018 abortions in Texas and 2547 out-of-state abortions among Texas residents. During the 6 months after SB 8, there were 13802 abortions in Texas and 8740 out-of-state abortions among Texas residents. Compared with the month before implementation of SB 8, the number of Texas facility–based abortions significantly decreased from 5451 to 2169 (difference, 3282 [95% CI, 3171 to 3396]; incidence rate ratio [IRR], 0.43 [95% CI, 0.36-0.51]) in the month after SB 8 was implemented. The number of out-of-state abortions among Texas residents significantly increased from 222 to 1332 (difference, 1110 [95% CI, 1047-1177]; IRR, 5.38 [95% CI, 4.19-6.91]). Overall, the total documented number of Texas facility–based and out-of-state abortions among Texas residents significantly decreased from 5673 to 3501 (absolute change, 2172 [95% CI, 2083 to 2265]; IRR, 0.67 [95% CI, 0.56-0.79]) in the first month after SB 8 was implemented compared with the previous month. Out-of-state abortions among Texas residents obtained at 12 or more weeks of gestation increased from 17.1% (221/1291) to 31.0% (399/1289) (difference, 178 [95% CI, 153-206]) during the period between September 2021 and February 2022 (P<.001 for trend).

Conclusions and Relevance  Among a sample of abortion facilities, the 2021 Texas law banning abortion in early pregnancy (SB 8) was significantly associated with a decrease in the documented total of facility-based abortions in Texas and obtained by Texas residents in surrounding states in the first month after implementation compared with the previous month. Over the 6 months following SB 8 implementation, the percentage of out-of-state abortions among Texas residents obtained at 12 or more weeks of gestation significantly increased.

DOI: 10.1001/jama.2022.20423

Source: https://jamanetwork.com/journals/jama/article-abstract/2798216