States with more restrictive abortion laws following the U.S. Supreme Court's 2022 Dobbs v. Jackson Women's Health Organization decision have a higher incidence of babies born with cyanotic congenital heart disease (CCHD), according to a new study being presented at ACC.25 in Chicago.

In the retrospective study, the first to look at rates of congenital heart defects since the decision, Stephanie Tseng, MD, et al., used birth certificate data from the U.S. Centers for Disease Control and Prevention to look at live births from 2016-2024 in twenty-nine states, 20 classified as having "very or the most restrictive" abortion laws, and nine classified as having "very or the most protective" laws.

Results showed that the incidence of CCHD live births rose in the restrictive cohort but stayed relatively stable in the protective cohort following the Dobbs decision. Additionally, the difference between the two cohorts increased after Dobbs and exceeded the estimate calculated in the absence of the decision. The median monthly overage in the expected to observed difference was 9.6 per 100,000 births.

Tseng notes that the study only shows potential associations and is not designed to identify the causes of the trends that were observed. Other factors besides abortion access could explain the differences between states, such as potential differences in prenatal care and timing of CCHD diagnosis, or differences in maternal risk factors such as diabetes that could affect the likelihood of having a baby with CCHD.

"If the trend toward an increasing number of CCHD births is true, then there will be a larger population of patients with [CCHD] that will need [early and lifelong] health care," states Tseng. "The health care system, particularly in states with restrictive policies, will need to prepare for these patients, as we know that CCHD patients have higher health care utilization needs. This includes health care costs, resources and [an increased] need for health care workers. There will be non-financial physical and emotional strains on families as well."

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Congenital Heart Disease

Keywords: ACC Annual Scientific Session, ACC25, Heart Defects, Congenital, Pregnancy