Sexual Orientation Disparities in Pregnancy and Infant Outcomes
Sexual Orientation Disparities in Pregnancy and Infant Outcomes
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DOI：
10.1007/s10995-018-2595-x
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发表时间：
2019-01-01
影响因子：
2.3
通讯作者：
Hughes, Tonda L.
中科院分区：
文献类型：
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作者：
Everett, Bethany G.;Kominiarek, Michelle A.;Hughes, Tonda L.
尽管大量研究记录了性少数妇女的多种孕前风险因素，但对性少数妇女（SMW）的母婴健康知之甚少。这项研究使用了2006-2015年全国家庭增长调查（NSFG）的数据，调查了怀孕和分娩结果中的性取向不平等，包括流产、死胎、早产和出生体重。方法报告19,955例符合研究条件的妊娠和15,996例单胎活产。性取向是通过自我报告的身份和同性性经历（异性恋- wsm[只报告与男性发生性关系的女性]；异性恋- wsw[报告与女性发生性关系的女性]；双性恋和女同性恋）来测量的。采用逻辑回归模型调整了母亲的几个特征。结果与异性恋- wsm相比，异性恋- wsw （OR 1.25, 95% CI 1.00-1.58）和双性恋和女同性恋妇女（OR 1.77, 95% CI 1.34-2.35）更容易报告流产，双性恋和女同性恋妇女更容易报告妊娠以死产结束（OR 2.85, 95% CI 1.40-5.83）。与异性恋女性相比，女同性恋女性更有可能报告低出生体重婴儿（OR 2.64, 95% CI 1.38-5.07），双性恋和女同性恋女性更有可能报告非常早产（OR 1.84, 95% CI 1.11-3.04）。本研究记录了怀孕和分娩结果中显著的性取向不平等。需要进行更多的研究，以了解造成不同结果的机制，并制定干预措施，以改善性少数群体妇女的母婴健康。
Objectives Little is known about maternal and infant health among sexual minority women (SMW), despite the large body of research documenting their multiple preconception risk factors. This study used data from the 2006-2015 National Survey of Family Growth (NSFG) to investigate sexual orientation inequities in pregnancy and birth outcomes, including miscarriage, stillbirth, preterm birth, and birth weight. Methods Women reported 19,955 study eligible pregnancies and 15,996 singleton live births. Sexual orientation was measured using self-reported identity and histories of same-sex sexual experiences (heterosexual-WSM [women who only report sex with men]; heterosexual-WSW [women who report sex with women]; bisexual, and lesbian). Logistic regression models were used that adjusted for several maternal characteristics. Results Compared to heterosexual-WSM, heterosexual-WSW (OR 1.25, 95% CI 1.00-1.58) and bisexual and lesbian women (OR 1.77, 95% CI 1.34-2.35) were more likely to report miscarriage, and bisexual and lesbian women were more likely to report a pregnancy ending in stillbirth (OR 2.85, 95% CI 1.40-5.83). Lesbian women were more likely to report low birth weight infants (OR 2.64, 95% CI 1.38-5.07) and bisexual and lesbian women were more likely to report very preterm births (OR 1.84, 95% CI 1.11-3.04) compared to heterosexual-WSM. Conclusionsfor Practice This study documents significant sexual orientation inequities in pregnancy and birth outcomes. More research is needed to understand the mechanisms that underlie disparate outcomes and to develop interventions to improve sexual minority women's maternal and infant health.