{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:56:03Z","timestamp":1785473763949,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital heart defects (CHD) are the most common congenital anomaly with increasing prevalence and expectation of prenatal diagnosis and comprehensive counseling. Recent changes in state and federal laws have altered the availability of some services, potentially affecting counseling content. We describe the association between access to services and content of prenatal counseling in critical CHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An anonymous survey was distributed to fetal cardiologists. Respondents indicated characteristics of their counseling discussion for newly diagnosed hypoplastic left heart syndrome, including intervention, palliative care involvement, and termination. Chi\u2010square analysis assessed whether counseling content differed based on institutional services available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 138 respondents, there was a statistically significant association between institutional access to termination and whether providers included termination as an option in counseling. In multivariable logistic regression analyses, this association remained significant after accounting for practice characteristics, with no evidence that geographic setting, practice size, or institutional affiliation modified the association. Providers at institutions where termination was not available were consistently less likely to include this pregnancy option in counseling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Providers at institutions where termination is not available are less likely to include this pregnancy option in counseling, suggesting that institutional services may alter patients' access to comprehensive counseling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70094","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T15:41:11Z","timestamp":1771256471000},"page":"382-389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Institutional Services and Counseling Options in Fetal Cardiology"],"prefix":"10.1002","volume":"46","author":[{"given":"Caroline","family":"Valdes","sequence":"first","affiliation":[{"name":"Texas A&amp;M College of Medicine  Bryan Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne S.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Pediatrics Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1503-7100","authenticated-orcid":false,"given":"Christina","family":"Ronai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Cardiology Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin S.","family":"Haxel","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Golisano Children's Hospital at University of Vermont Health  Burlington Vermont USA"},{"name":"Department of Pediatrics Larner College of Medicine at the University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"What Are Congenital Heart Defects? NIH National Heart Lung and Blood Institute (March 2022) accessed June 13 2025 https:\/\/www.nhlbi.nih.gov\/health\/congenital\u2010heart\u2010defects#:~:text=Congenital%20heart%20defects%2C%20or%20diseases births%20in%20the%20United%20States."},{"key":"e_1_2_13_3_1","unstructured":"The Impact of Congenital Heart Defects \u201cAmerican Heart Association\u201d Accessed June 14 2025 https:\/\/www.heart.org\/en\/health\u2010topics\/congenital\u2010heart\u2010defects\/the\u2010impact\u2010of\u2010congenital\u2010heart\u2010defects."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.03.008"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/apc.APC_125_16"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ppedcard.2020.101312"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11936\u2010017\u20100502\u20101"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"e_1_2_13_9_1","unstructured":"Dobbs v. Jackson Women\u2019s Health Organization. \u201cNational Constitution Center \u201d (2022). Accessed June 13 2025 https:\/\/constitutioncenter.org\/the\u2010constitution\/supreme\u2010court\u2010case\u2010library\/dobbs\u2010v\u2010jackson\u2010womens\u2010health\u2010organization."},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26107"},{"key":"e_1_2_13_11_1","volume-title":"Interactive Map: US Abortion Policies and Access After Roe","year":"2025"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246\u2010025\u201003783\u2010y"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6706"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/17455057231152373"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2013.05.003"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6901"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1071"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000003425"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/pedsos.2024\u2010000411"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2025.2469850"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000005291"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2016.11.006"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2025.114784"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/s1047951120000128"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372\u2010019\u20100490\u2010y"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246\u2010024\u201003535\u20104"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951117002761"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.70094","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pd.70094","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.70094","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:20:16Z","timestamp":1773249616000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.70094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/pd.70094"],"URL":"https:\/\/doi.org\/10.1002\/pd.70094","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"assertion":[{"value":"2025-10-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}