Decreasing Births and NICU Admissions for Congenital Anomalies in the United States, 2016-2023

Abstract Objectives: Evaluate trends in U.S. births and NICU admissions for congenital anomalies Study Design: This population-based, cross-sectional study included all births with congenital anomalies in the U.S. from 2016 to 2023 from CDC WONDER. Trends in anomaly-associated NICU admissions and births were assessed. Results: From 2016-2023, NICU admissions for anomalies decreased from 18.5 to 18 per 10,000 live births (annual percent change (APC), -0.4%; 95% CI, -0.7% to -0.2%). Admissions for gastroschisis showed the greatest decline; admissions for cyanotic congenital heart disease (CCHD) increased. NICU trends approximated birth trends for neonatal surgical anomalies, and not for non-surgical or life-limiting anomalies. Conclusions: Births and NICU admissions for congenital anomalies declined modestly in the U.S. from 2016 to 2023 with births decreasing to a greater degree than NICU admissions. Anomaly-specific considerations such as need for neonatal surgical repair, comorbid diagnoses requiring NICU care, and parental goals of care may explain these differences.