Time-Series Analysis of Infant Mortality Disaggregated by Race, Ethnicity, and Specific Causes After 6-Week Abortion Ban.

Abstract

In 2021, Texas Senate Bill 8 banned abortion after 6 weeks of gestation. Prior research has shown persistent differences in infant mortality by race/ethnicity and an overall increase in infant mortality in association with Senate Bill 8. It is unclear whether recent changes may be differential by race, ethnicity, and causes of death. Using a population-based cohort of all infants aged <1 years in Texas and 26 abortion rights protective states, a controlled interrupted time-series analysis used Poisson regression to assess the association between changes in the law and monthly counts of infant deaths, adjusting for both long-term trends and seasonality. Monthly data were obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research dataset from January 2018 through December 2024. Overall mortality in Texas was 17% higher after the 6-week ban than before (95% CI=9%, 25%) and 10% higher than in comparison states. In disaggregated race and ethnicity data, non-Hispanic Black mortality in Texas was 21% higher (95% CI=5%, 38%) and 17% higher than in comparison states. Cause-specific mortality in Texas was also found to be 21% higher for congenital anomalies (95% CI=6%, 39%) and 19% higher than in comparison states. This study found evidence of increased infant mortality in Texas after the implementation of a 6-week abortion ban with differential impact identified for non-Hispanic Black infants in a comparison analysis. These results build on growing evidence and should guide and inform policy and public health interventions addressing increased infant mortality.