新生儿结局中与性取向相关的差异。

Sexual Orientation-Related Disparities in Neonatal Outcomes.

作者信息

Chakraborty Payal, Reynolds Colleen A, McKetta Sarah, Soled Kodiak R S, Huang Aimee K, Monseur Brent, Corman Jae Downing, Obedin-Maliver Juno, Eliassen A Heather, Chavarro Jorge E, Austin S Bryn, Everett Bethany, Haneuse Sebastien, Charlton Brittany M

机构信息

Department of Population Medicine, Harvard Medical School, the Harvard Pilgrim Health Care Institute, the Department of Epidemiology, the Department of Social and Behavioral Sciences, the Department of Nutrition, and the Department of Biostatistics, Harvard T.H. Chan School of Public Health, Clinical Analytics, FOLX Health, the Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, and the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; the Division of Reproductive Endocrinology and Infertility, Stanford School of Medicine, Stanford, and the Department of Obstetrics and Gynecology and the Department of Epidemiology and Population Health, Stanford School of Medicine, Palo Alto, California; and the Department of Sociology, University of Utah, Salt Lake City, Utah.

出版信息

Obstet Gynecol. 2024 Dec 1;144(6):843-851. doi: 10.1097/AOG.0000000000005747. Epub 2024 Oct 3.

DOI:10.1097/AOG.0000000000005747

PMID:39361956

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11602367/

Abstract

OBJECTIVE

To evaluate whether disparities exist in adverse neonatal outcomes among the offspring of lesbian, gay, bisexual, and other sexually minoritized (LGB+) birthing people.

METHODS

We used longitudinal data from 1995 to 2017 from the Nurses' Health Study II, a cohort of nurses across the United States. We restricted analyses to those who reported live births (N=70,642) in the 2001 or 2009 lifetime pregnancy questionnaires. Participants were asked about sexual orientation identity (current and past) and same-sex attractions and partners. We examined preterm birth, low birth weight, and macrosomia among 1) completely heterosexual; 2) heterosexual with past same-sex attractions, partners, or identity; 3) mostly heterosexual; 4) bisexual; and 5) lesbian or gay participants. We used log-binomial models to estimate risk ratios for each outcome and weighted generalized estimating equations to account for multiple pregnancies per person over time and informative cluster sizes.

RESULTS

Compared with completely heterosexual participants, offspring born to parents in all LGB+ groups combined (groups 2-5) had higher estimated risks of preterm birth (risk ratio 1.22, 95% CI, 1.15-1.30) and low birth weight (1.27, 95% CI, 1.15-1.40) but not macrosomia (0.98, 95% CI, 0.94-1.02). In the subgroup analysis, risk ratios were statistically significant for heterosexual participants with past same-sex attractions, partners, or identity (preterm birth 1.25, 95% CI, 1.13-1.37; low birth weight 1.32, 95% CI, 1.18-1.47). Risk ratios were elevated but not statistically significant for lesbian or gay participants (preterm birth 1.37, 95% CI, 0.98-1.93; low birth weight 1.46, 95% CI, 0.96-2.21) and bisexual participants (preterm birth 1.29, 95% CI, 0.85-1.93; low birth weight 1.24, 95% CI, 0.74-2.08).

CONCLUSION

The offspring of LGB+ birthing people experience adverse neonatal outcomes, specifically preterm birth and low birth weight. These findings highlight the need to better understand health risks, social inequities, and health care experiences that drive these adverse outcomes.

摘要

目的

评估女同性恋、男同性恋、双性恋及其他性少数群体（LGB+）生育者的后代在不良新生儿结局方面是否存在差异。

方法

我们使用了来自美国护士健康研究II（Nurses' Health Study II）1995年至2017年的纵向数据，该研究队列涵盖美国各地的护士。我们将分析限制在2001年或2009年终身妊娠问卷中报告活产的人群（N = 70,642）。参与者被问及性取向身份（当前和过去）以及同性吸引和伴侣情况。我们检查了以下几类人群中的早产、低出生体重和巨大儿情况：1）完全异性恋者；2）有过同性吸引、伴侣或身份认同的异性恋者；3）主要为异性恋者；4）双性恋者；5）女同性恋或男同性恋参与者。我们使用对数二项模型估计每种结局的风险比，并使用加权广义估计方程来考虑每人随时间的多次妊娠以及信息性聚类大小。

结果

与完全异性恋参与者相比，所有LGB+组（第2 - 5组）的父母所生后代早产（风险比1.22，95%置信区间，1.15 - 1.30）和低出生体重（1.27，95%置信区间，1.15 - 1.40）的估计风险更高，但巨大儿风险无差异（0.98，95%置信区间，0.94 - 1.02）。在亚组分析中，有过同性吸引、伴侣或身份认同的异性恋参与者的风险比具有统计学意义（早产1.25，95%置信区间，1.13 - 1.37；低出生体重1.32，95%置信区间，1.18 - 1.47）。女同性恋或男同性恋参与者（早产1.37，95%置信区间，0.98 - 1.93；低出生体重1.46，95%置信区间，0.96 - 2.21）和双性恋参与者（早产1.29，95%置信区间，0.85 - 1.93；低出生体重1.24，95%置信区间，0.74 - 2.08）的风险比有所升高，但无统计学意义。