Down syndrome birth rate post Dobbs decision: has it changed?

OBJECTIVE: In 2022, the U.S. Supreme Court decision on Dobbs v. Jackson Women's Health Organization changed abortion access. We evaluated birth rates of Down syndrome (DS) before and after the Dobbs decision hypothesizing similarity to cyanotic congenital heart disease. STUDY DESIGN: Retrospective cohort study of live births utilizing 2016 - 2025 CDC birth certificate registry data stratified by DS and by state abortion access categories (restrictive and protective) based on the Guttmacher Institute. Incidence of DS and the difference in incidence between state cohorts were modeled and compared between pre- and post-Dobbs periods using segmented linear regression. RESULTS: Incidence of DS live births remained stable in restrictive and protective states pre- and post-Dobbs. Segmented regression models revealed no significant changes in monthly incidence in the post-Dobbs era nationally compared to pre-Dobbs. CONCLUSIONS: Mean monthly incidence of DS in live-born infants using CDC birth certificate data did not increase after the Dobbs decision.