Restrictive abortion laws linked to offspring heart disease

Restrictive abortion laws linked to offspring heart disease | Image Credit: © _KUBE_ - © _KUBE_ - stock.adobe.com.

Restrictive state abortion laws are associated with an increase in babies born with cyanotic congenital heart disease (CCHD), according to a study to be presented at the American College of Cardiology’s Annual Scientific Session.¹

Impact of Dobbs

As the first study to assess severe heart defects since the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision in June 2022, investigators found an increase in CCHD incidence among states with restrictive abortion laws. In comparison, CCHD incidence remained steady in states with abortion protections.

“The health care system… will need to prepare for these patients, as we know that CCHD patients have higher health care utilization needs,” said Stephanie Tseng, MD, assistant professor and pediatric cardiologist at Nationwide Children’s Hospital. “This includes health care costs, resources and [an increased] need for health care workers.”

Study methodology

The study evaluated CCHD rates using birth certificate date from the US Centers for Disease Control and Prevention. Babies born from 2016 to 2024 across 29 states were included in the analysis. Of states, 20 enacted restrictive abortion laws while the remaining 9 had the most protective abortion policies following the Dobbs decision.

CCHD, including multiple heart defects leading to less oxygen being delivered to the body, is often diagnosed through ultrasound scans performed in the second trimester of pregnancy. Death within 1 year of birth occurs in 15% to 20% of babies with CCHD, and survivors often need lifelong care including regular cardiology visits.

Heart defects present in approximately 1 in 100 babies worldwide, with approximately 40,000 US infants impacted per year.² Advances in treatment allow over 90% of these infants to survive to adulthood, highlighting the importance of detection and care.

Data highlights

A difference of 9.6 babies with CCHD per 100,000 births was reported between states with abortion restrictions vs abortion protections when evaluating the median monthly average 2 years after Dobbs.¹The degree of difference was further highlighted in an analysis reporting the difference in observed CCHD incidence over time vs the expected rate based on pre­-Dobbs trends.

The data indicated a moderate degree of difference between the observed and expected incidence. A higher actual incidence when compared to the predicted incidence was reported most months following Dobbs.

Tseng noted that only potential associations were reported in the study, rather than direct sources of the reported trends. Other factors potentially influencing differences between states include prenatal care differences, the timing of CCHD diagnosis, and maternal risk factors such as diabetes that impact the odds of offspring CCHD.

However, according to researchers, it may be possible that babies born to mothers who would have decided to terminate their pregnancies if they were living in a state with less restrictive laws are a major factor behind the differences between states.

Future considerations

“We’ve come a long way in caring for these individuals, but the mortality rate can still be high,” Tseng said. “Some of these defects can be quite severe and may not have good surgical options, and some families may consider pregnancy termination based on the outlook for the baby and the family.”

Limitations in the data prevented identification of specific CCHD diagnoses in each case, and when the condition was diagnosed. However, researchers recommended long-term evaluation of these trends.

References

1. Study shows rise in congenital heart defects in states with restrictive abortion laws. American College of Cardiology. March 18, 2025. Accessed March 18, 2025. https://www.eurekalert.org/news-releases/1077163.
2. Congenital heart disease. American College of Cardiology. Accessed March 19, 2025. https://www.cardiosmart.org/topics/congenital-heart-disease.