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Genetics

Poster Session 1

(354) Invasive Testing for Abnormal NIPT Before and After the Texas Heartbeat Act

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Texas passed the “Texas Heartbeat Act”, also known as Senate Bill 8, in 2021, which effectively banned abortions in the state of Texas after a fetal heartbeat is detected. This law was enacted on September 1st, 2021. Whether this law has impacted patient decision-making regarding invasive testing is unknown. We sought to determine the rate of uptake of invasive testing after an abnormal cell free DNA (cfDNA) before and after the enactment of the Texas Heartbeat Act on September 1st, 2021.

Study Design:

This was a retrospective cohort study of all genetic counseling visits for an abnormal cfDNA at our institution in Austin, Texas between 2019-2022. Information regarding demographics, abnormal cfDNA results, invasive testing, ultrasound anomalies, and pregnancy outcomes was collected. Chi square tests were used to compare groups before and after September 1st, 2021.

Results: 146 patients had genetic counseling visits for an abnormal NIPT between 2019-2022, 81 were done prior to September 1, 2021, and 65 after. Patient demographics were similar between groups, including maternal age, abnormal cfDNA result, language and public or private insurance. The rate of invasive testing did not change after the Texas Heartbeat Act (44% before, 37% after, p value 0.21). The type of invasive testing and the rate of pregnancy terminations also did not change. When stratifying by insurance status (public versus private), the rate of invasive testing and pregnancy termination did not change after the law was passed.

Conclusion: Restrictive laws in Texas have not changed the likelihood of patients to undergo invasive testing in our population. The rate of terminations for abnormal pregnancies also has not changed, including for those using public insurance or who are uninsured.