Disparities in perinatal outcomes among births to same-sex and different-sex married couples: a cross-sectional study using birth certificate data

Objective: To evaluate differences in birth outcomes for infants born to parents in same-sex versus different-sex marriages. Design: Cross-sectional study Subjects: Birth certificate data from Ohio for 318,616 singleton infants born to married parents from 2016 to 2020. Exposure: We estimated the as...

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Main Authors: Kendall A. Lawley, M.S., M.P.H., Brittany M. Charlton, Sc.D., Elizabeth Rubin, M.D., Paula Amato, M.D., Jae Corman, Ph.D.
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:F&S Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666334125000649
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author Kendall A. Lawley, M.S., M.P.H.
Brittany M. Charlton, Sc.D.
Elizabeth Rubin, M.D.
Paula Amato, M.D.
Jae Corman, Ph.D.
author_facet Kendall A. Lawley, M.S., M.P.H.
Brittany M. Charlton, Sc.D.
Elizabeth Rubin, M.D.
Paula Amato, M.D.
Jae Corman, Ph.D.
author_sort Kendall A. Lawley, M.S., M.P.H.
collection DOAJ
description Objective: To evaluate differences in birth outcomes for infants born to parents in same-sex versus different-sex marriages. Design: Cross-sectional study Subjects: Birth certificate data from Ohio for 318,616 singleton infants born to married parents from 2016 to 2020. Exposure: We estimated the associations of having a parent in a same-sex marriage (SSM) vs. a different-sex marriage (DSM). Main Outcome Measures: Preterm birth, low birth weight, macrosomia, small infant for gestational age, large infant for gestational age, and whether these outcomes differed by use of assisted reproductive technologies. Results: A total of 1,661 singletons were born to married birthing people in SSM. Preterm birth was more common in birthing persons in SSM compared with those in DSM (11.0% vs. 7.6%), and this difference remained significant on multivariate analyses controlling for covariates. Size for gestational age was similar among infants with parents in SSM and DSM. Among those who used assisted reproductive technologies, infants born to parents in SSM had a 1.58 (95% CI: 1.15, 2.12) higher odds of macrosomia compared with those in DSM. Conclusion: People in SSM may face modestly increased risks for some perinatal outcomes, including preterm birth. Understanding the risks and resiliency among diverse sexual minority populations may provide important insights into the ways in which people in same-sex partnerships achieve healthy perinatal outcomes.
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spelling doaj-art-cc7016a4d88e4ae987744e2a6bc0d45a2025-08-20T02:36:16ZengElsevierF&S Reports2666-33412025-06-016217718410.1016/j.xfre.2025.04.005Disparities in perinatal outcomes among births to same-sex and different-sex married couples: a cross-sectional study using birth certificate dataKendall A. Lawley, M.S., M.P.H.0Brittany M. Charlton, Sc.D.1Elizabeth Rubin, M.D.2Paula Amato, M.D.3Jae Corman, Ph.D.4Department of Epidemiology, University of Washington, Seattle, Washington; Correspondence: Kendall A. Lawley, M.S., M.P.H., Department of Epidemiology, University of Washington, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, Washington 98195.Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MassachusettsDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OregonDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OregonFolx Health, Boston, MassachusettsObjective: To evaluate differences in birth outcomes for infants born to parents in same-sex versus different-sex marriages. Design: Cross-sectional study Subjects: Birth certificate data from Ohio for 318,616 singleton infants born to married parents from 2016 to 2020. Exposure: We estimated the associations of having a parent in a same-sex marriage (SSM) vs. a different-sex marriage (DSM). Main Outcome Measures: Preterm birth, low birth weight, macrosomia, small infant for gestational age, large infant for gestational age, and whether these outcomes differed by use of assisted reproductive technologies. Results: A total of 1,661 singletons were born to married birthing people in SSM. Preterm birth was more common in birthing persons in SSM compared with those in DSM (11.0% vs. 7.6%), and this difference remained significant on multivariate analyses controlling for covariates. Size for gestational age was similar among infants with parents in SSM and DSM. Among those who used assisted reproductive technologies, infants born to parents in SSM had a 1.58 (95% CI: 1.15, 2.12) higher odds of macrosomia compared with those in DSM. Conclusion: People in SSM may face modestly increased risks for some perinatal outcomes, including preterm birth. Understanding the risks and resiliency among diverse sexual minority populations may provide important insights into the ways in which people in same-sex partnerships achieve healthy perinatal outcomes.http://www.sciencedirect.com/science/article/pii/S2666334125000649Perinatal outcomeshealth disparitiesLGBTQpreterm birthmacrosomia
spellingShingle Kendall A. Lawley, M.S., M.P.H.
Brittany M. Charlton, Sc.D.
Elizabeth Rubin, M.D.
Paula Amato, M.D.
Jae Corman, Ph.D.
Disparities in perinatal outcomes among births to same-sex and different-sex married couples: a cross-sectional study using birth certificate data
F&S Reports
Perinatal outcomes
health disparities
LGBTQ
preterm birth
macrosomia
title Disparities in perinatal outcomes among births to same-sex and different-sex married couples: a cross-sectional study using birth certificate data
title_full Disparities in perinatal outcomes among births to same-sex and different-sex married couples: a cross-sectional study using birth certificate data
title_fullStr Disparities in perinatal outcomes among births to same-sex and different-sex married couples: a cross-sectional study using birth certificate data
title_full_unstemmed Disparities in perinatal outcomes among births to same-sex and different-sex married couples: a cross-sectional study using birth certificate data
title_short Disparities in perinatal outcomes among births to same-sex and different-sex married couples: a cross-sectional study using birth certificate data
title_sort disparities in perinatal outcomes among births to same sex and different sex married couples a cross sectional study using birth certificate data
topic Perinatal outcomes
health disparities
LGBTQ
preterm birth
macrosomia
url http://www.sciencedirect.com/science/article/pii/S2666334125000649
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