Abstract
Objectives
Patients with modified World Health Organization (mWHO) class IV cardiovascular conditions
are at high risk of severe maternal morbidity and mortality in pregnancy and are advised
to avoid pregnancy or consider abortion if they become pregnant. We aimed to determine
if state-level abortion policy is associated with receiving an abortion in this high-risk
population.
Study design
We conducted a descriptive retrospective cross-sectional study of abortion among people
15-44 years of age with mWHO class IV cardiovascular conditionsstate policy on abortion
using US claims data from United health Group from 2017 to 2020.
Results
There was a statistically significant association between restrictive abortion policy
at that state level and lower number of pregnancies ending in abortions in this high-risk
group.
Conclusions
States with the most restrictive abortion policy have the lowest proportion of pregnancies
ending in abortion among patients with mWHO class IV cardiovascular conditions.
Implications
Variation in receiving abortion by state of residence among patients with mWHO class
IV cardiovascular conditions may indicate an impending rise in severe maternal morbidity
and mortality related to cardiovascular disease in pregnancy, and the risk factor
is where a person lives. This trend may be exacerbated by the Supreme Court Decision
Dobbs v Jackson Women’s Health.
Keywords
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References
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Article info
Publication history
Published online: May 03, 2023
Accepted:
April 25,
2023
Received in revised form:
April 24,
2023
Received:
February 15,
2023
Publication stage
In Press Corrected ProofFootnotes
☆Conflicts of interest: None.
☆☆Funding: None.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
