Sexual orientation differences in teen pregnancy and hormonal contraceptive use: an examination across 2 generations
Sexual orientation differences in teen pregnancy and hormonal contraceptive use: an examination across 2 generations
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DOI：
10.1016/j.ajog.2013.06.036
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发表时间：
2013-09-01
影响因子：
9.8
通讯作者：
Austin, Bryn
中科院分区：
文献类型：
--
作者：
Charlton, Brittany M.;Corliss, Heather L.;Austin, Bryn
目的：探讨性取向是否与 2 个代际队列中青少年女性怀孕和激素避孕使用的差异相关。 研究设计：数据收集自护士健康研究 II (NHSII) 中出生于 1947 年至 1964 年的 91,003 名妇女，以及她们的 6,463 名子女，出生于 1982 年至 1987 年，参加了成长研究今日研究（GUTS）。使用对数二项式模型来估计性少数群体与异性恋者相比青少年怀孕和激素避孕使用的风险比，并使用荟萃分析技术来比较这两个队列。 结果：总体而言，与 GUTS 相比，NHSII 中青少年激素避孕使用率较低，青少年怀孕率较高。在这两个队列中，与异性恋同龄人相比，女同性恋者在青少年时期使用激素避孕的可能性较小，而其他性少数群体则更有可能。两个队列中的所有性少数群体（NHSII 女同性恋除外）的青少年怀孕风险均显着增加，风险比范围为 1.61（95% 置信区间，0.40-6.55）至 5.82（95% 置信区间，2.89-11.73）。在 GUTS 参与者中，NHSII 母亲在青少年时期怀孕与青少年怀孕无关。最后，两个队列之间发现了显着的异质性。结论：青春期性少数群体的怀孕风险一直且持续增加。需要公共卫生和临床努力来解决这一人群中的青少年怀孕问题。
OBJECTIVE: To examine whether sexual orientation is associated with disparities in teen pregnancy and hormonal contraception use among adolescent females in 2 intergenerational cohorts.STUDY DESIGN: Data were collected from 91,003 women in the Nurses' Health Study II (NHSII), born between 1947-1964, and 6463 of their children, born between 1982-1987, enrolled in the Growing Up Today Study (GUTS). Log-binomial models were used to estimate risk ratios for teen pregnancy and hormonal contraception use in sexual minorities compared with heterosexuals and metaanalysis techniques were used to compare the 2 cohorts.RESULTS: Overall, teen hormonal contraception use was lower and teen pregnancy was higher in NHSII than GUTS. In both cohorts, lesbians were less likely, whereas the other sexual minorities were more likely, to use hormonal contraception as teenagers compared with their heterosexual peers. All sexual minority groups in both cohorts, except NHSII lesbians, were at significantly increased risk for teen pregnancy, with risk ratios ranging from 1.61 (95% confidence interval, 0.40-6.55) to 5.82 (95% confidence interval, 2.89-11.73). Having an NHSII mother who was pregnant as a teen was not associated with teen pregnancy in GUTS participants. Finally, significant heterogeneity was found between the 2 cohorts.CONCLUSION: Adolescent sexual minorities have been, and continue to be, at increased risk for pregnancy. Public health and clinical efforts are needed to address teen pregnancy in this population.