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.

中文翻译：

---

新生儿结局中与性取向相关的差异。


目的 评估女同性恋、男同性恋、双性恋和其他性少数群体 （LGB+） 分娩者的后代的不良新生儿结局是否存在差异。方法 我们使用了 1995 年至 2017 年的纵向数据，这些数据来自护士健康研究 II，该研究是美国各地的护士队列。我们将分析限制在 2001 年或 2009 年终生妊娠问卷中报告活产 （N=70,642） 的人。参与者被问及性取向身份（现在和过去）以及同性吸引力和伴侣。我们检查了早产、低出生体重和巨大儿 1） 完全异性恋;2） 过去有同性吸引力、伴侣或身份的异性恋;3） 主要是异性恋;4） 双性恋;5） 女同性恋或男同性恋参与者。我们使用对数二项式模型来估计每个结局的风险比，并使用加权广义估计方程来解释每人随时间推移的多胎妊娠和信息丰富的集群规模。结果与完全异性恋参与者相比，所有 LGB+ 组（第 2-5 组）父母所生的后代估计早产风险较高 （风险比 1.22,95% CI，1.15-1.30） 和低出生体重 （1.27,95% CI，1.15-1.40），但巨大儿 （0.98， 95% CI， 0.94-1.02） 则不然。在亚组分析中，对于过去有同性吸引力、伴侣或身份的异性恋参与者，风险比具有统计学意义（早产 1.25,95% CI，1.13-1.37;低出生体重 1.32,95% CI，1.18-1.47）。女同性恋或男同性恋参与者 （早产 1.37， 95% CI， 0.98-1.93;低出生体重 1.46， 95% CI， 0.96-2.21） 和双性恋参与者 （早产 1.29， 95% CI， 0.85-1.93;低出生体重 1.24， 95% CI， 0.结论 LGB+ 分娩者的后代会出现不良的新生儿结局，特别是早产和低出生体重。这些发现强调了更好地了解导致这些不良结果的健康风险、社会不平等和医疗保健经历的必要性。