Pregnancy Termination Policy and Cleft Lip and Palate

Area of Science:

• Public Health
• Medical Research
• Demographic Studies

Background:

• Restrictive termination of pregnancy (TOP) policies may correlate with increased congenital abnormalities.
• Cleft lip and/or palate (CL/P) is a significant congenital abnormality.
• Understanding the impact of policy on birth outcomes is crucial for public health initiatives.

Purpose of the Study:

• To assess the association between statewide termination of pregnancy (TOP) restriction laws and cleft lip and/or palate (CL/P) incidence.
• To identify demographic factors that mediate the relationship between TOP restriction and CL/P.
• To provide data informing public health strategies and policy decisions.

Main Methods:

• Comparative state analysis of CL/P incidence trends before and after TOP restriction laws.
• Utilized Michigan (restrictive policy) and New York (non-restrictive policy) as study populations.
• Employed multivariate models to adjust for confounding demographic variables.

Main Results:

• Michigan showed a significant increase in CL/P incidence (19.1%) compared to New York's decrease (-7.31%).
• The adjusted difference in CL/P incidence between Michigan and New York was 53.3% (P < 0.001).
• Increases were most pronounced among Black and Hispanic infants and those from lower income quartiles.

Conclusions:

• Statewide termination of pregnancy (TOP) restrictions are associated with increased cleft lip and/or palate (CL/P) incidence.
• Demographic factors, including race/ethnicity and socioeconomic status, mediate this association.
• Future policy changes may lead to a greater number of infants requiring treatment for CL/P.