Work

The Dobbs Decision and Incidence of Live Births With Cyanotic Congenital Heart Disease

Year: 2025

Type: article

Abstract: BACKGROUND AND OBJECTIVES In 2022, the US Supreme Court decision on Dobbs v Jackson Women’s Health Organization resulted in differing access to abortion across states. This study evaluated birth rates of infants with cyanotic congenital heart disease (CCHD) before and after Dobbs between states with restrictive and protective abortion policies. We hypothesized that live births with CCHD increased in states with restrictive policies after Dobbs. METHODS This retrospective cohort study included live births from 2016–2024 using Centers for Disease Control and Prevention birth certificate registry data. The population was stratified by the presence of CCHD and subset into 2 cohorts by state abortion access categories based on the Guttmacher Institute: (1) very or most restrictive states and (2) very or most protective states. Differences between state cohorts in incidence of live births with CCHD before and after Dobbs were modeled and forecasted using autoregressive integrated moving average models with 95% prediction intervals informed by pre-Dobbs residuals. RESULTS Incidence of CCHD live births increased in restrictive states but remained stable in protective states post-Dobbs. An increasing difference in CCHD incidence between restrictive and protective states was observed post-Dobbs, exceeding model estimated birth rates in the hypothetical absence of the Dobbs decision. Post-Dobbs, 4/24 (17%) months exceeded the hypothetical Dobbs-free 95% prediction interval. CONCLUSIONS In the post-Dobbs era, CCHD birth rates have diverged between states with restrictive and protective abortion policies. This reflects a greater CCHD population after Dobbs in restrictive states, which could impact their health care system. Future studies should further explore these findings and investigate needs for additional resource allocation.

Source: Pediatrics Open Science

DOI: 10.1542/pedsos.2024-000411