%0 Journal Article
%T Sexual orientation disparities in gestational diabetes and hypertensive disorders of pregnancy.
%A Chakraborty P
%A Everett BG
%A Reynolds CA
%A Hoatson T
%A Stuart JJ
%A McKetta SC
%A Soled KRS
%A Huang AK
%A Chavarro JE
%A Eliassen AH
%A Obedin-Maliver J
%A Austin SB
%A Rich-Edwards JW
%A Haneuse S
%A Charlton BM
%J Paediatr Perinat Epidemiol
%V 0
%N 0
%D 2024 Jul 1
%M 38949425
%F 3.103
%R 10.1111/ppe.13101
%X <B>BACKGROUND: </B>Sexual minority (SM) individuals (e.g., those with same-sex attractions/partners or who identify as lesbian/gay/bisexual) experience a host of physical and mental health disparities. However, little is known about sexual orientation-related disparities in gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP; gestational hypertension [gHTN] and preeclampsia).<BR><B>OBJECTIVE: </B>To estimate disparities in GDM, gHTN and preeclampsia by sexual orientation.<BR><B>METHODS: </B>We used data from the Nurses' Health Study II-a cohort of nurses across the US enrolled in 1989 at 25-42 years of age-restricted to those with pregnancies ≥20 weeks gestation and non-missing sexual orientation data (63,518 participants; 146,079 pregnancies). Our primary outcomes were GDM, gHTN and preeclampsia, which participants reported for each of their pregnancies. Participants also reported their sexual orientation identity and same-sex attractions/partners. We compared the risk of each outcome in pregnancies among heterosexual participants with no same-sex experience (reference) to those among SM participants overall and within subgroups: (1) heterosexual with same-sex experience, (2) mostly heterosexual, (3) bisexual and (4) lesbian/gay participants. We used modified Poisson models to estimate risk ratios (RR) and 95% confidence intervals (CI), fit via weighted generalised estimating equations, to account for multiple pregnancies per person over time and informative cluster sizes.<BR><B>RESULTS: </B>The overall prevalence of each outcome was ≤5%. Mostly heterosexual participants had a 31% higher risk of gHTN (RR 1.31, 95% CI 1.03, 1.66), and heterosexual participants with same-sex experience had a 31% higher risk of GDM (RR 1.31, 95% CI 1.13, 1.50), compared to heterosexual participants with no same-sex experience. The magnitudes of the risk ratios were high among bisexual participants for gHTN and preeclampsia and among lesbian/gay participants for gHTN.<BR><B>CONCLUSIONS: </B>Some SM groups may be disparately burdened by GDM and HDP. Elucidating modifiable mechanisms (e.g., structural barriers, discrimination) for reducing adverse pregnancy outcomes among SM populations is critical.