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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
Abstract Award
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Foundation Awardee

Poster Session 3

Category: Public Health/Global Health

Poster Session 3

(865) Changes in Congenital Malformations in the Post-Dobbs US: A State-Level Public Health Assessment

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Objective:
To examine whether state-level rates of live births with congenital malformations changed following the Dobbs supreme court decision.

Study Design:
Retrospective analysis of the Centers for Disease Control and Prevention’s Natality live birth database, with detailed geographical data available (2018-2023). We compared rates of live births with major congenital and/or chromosomal malformations in each state before and after the Dobbs ruling on June 24, 2022. The period from July-December 2022 was considered transitional and excluded from the analysis. Pearson Chi Square testing was used with statistical significance set at p < 0.05.

Results:
The prevalence of live births with congenital malformations varies significantly among states in both the pre and post Dobbs decision periods (pre-Dobbs 0.11%-1.29%, and post-Dobbs 0.13%-1.40%) (Figure 1). In addition, significant variations were noted in the change in prevalence of congenital anomalies between these two time periods (odds ratios (OR) ranging from 0.49-2.42). While a substantial decrease in congenital anomalies was noted in Georgia, Kentucky, Mississippi, Oregon, Rhode Island, Tennessee, Texas, and Wisconsin (OR range 0.49-0.79), a notable increase was noted in California, Delaware, Florida, Hawaii, Maine, Michigan, and Washington (OR range 1.21-2.42) (Figure 2). P-value of 0.01 was calculated.

Conclusion:
Significant state level variations in the prevalence of live births with congenital anomalies were observed during both the pre and post Dobbs periods. Moreover, the magnitude and direction of rate changes post-Dobbs varied markedly by state, with some experiencing notable increases and others substantial decreases. Further state-level investigation is warranted to elucidate the root causes of these divergent trends. Nevertheless, underlying factors such as disparities in access to prenatal care, availability of legal pregnancy termination, cultural and demographic differences, nutritional status, and environmental exposures may be contributing to this disparity.