Severe Early Pregnancy Morbidity at a Tertiary Care Referral Center After the Dobbs Decision

The objectives of our study were to estimate trends in severe early pregnancy morbidity in pregnant individuals at less than 24 weeks of gestation at a referral center in an abortion-restricted environment and to assess differences after the Dobbs v. Jackson Women's Health Organization decision. We measured severe early pregnancy morbidity from January 2017 to December 2023 using billing codes, transfusion records, and intensive care transfers. We verified events and assessed preventability using chart review. We performed an interrupted time series analysis evaluating whether the level or slope of the severe early pregnancy morbidity rate varied with the Dobbs decision. We identified 407 severe early pregnancy morbidity events among 46,181 pregnancies. We noted no significant changes in the rate of total severe early pregnancy morbidity before and after the Dobbs decision, but we did note a significant level increase of 19 events per 100 total events (95% CI, 8.9-29.8) in the rate of preventable severe early pregnancy morbidity.