Legacies and Futures: Measuring Roles of Resilience and Vulnerability in Pregnancy and Birth Outcomes

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

945 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-05-17

Study Completion Date

2025-09-30

Brief Summary

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Pregnancy care typically assumes patients are heterosexual married women whose gender matches their assigned sex (i.e., cisgender), stigmatizing patients and creating limitations, blocking affirming care. Consequently, lesbian, gay, bisexual, queer, intersex, asexual, and/or transgender (LGBTQIA+) parents face minority stress as discrimination in antenatal care. This mixed-methods study assesses stressors and resilience factors on pregnancy and birth outcomes. LGBTQIA+ pregnant parents (n=200) are case-matched with cisheterosexual peers (n=600). Primary data comes from two panel surveys, one antenatally and one postpartum, combined with medical records. A sub-sample (n=30) will complete a journal between surveys. Findings will inform care guidelines and provider training.

Detailed Description

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Patients using reproductive health services, like care during pregnancy (called antenatal care), are most often assumed to be heterosexual married women whose gender matched their sex assigned at birth (i.e., cisgender). Due to these assumptions, pregnancy care procedures are based on a sweeping assumption of who becomes pregnant and gives birth. This assumption is based on the pregnant person's gender and/or sexual orientation. As a result of this assumption, parents who are lesbian, gay, bisexual, queer, intersex, asexual, non-binary, and/or transgender (LGBTQIA+) can experience stress in the form of stigma, prejudice, and discrimination (i.e. "minority stress"). In the United Kingdom, there are 525,000 LGBTQIA+ potential gestational patients who may face this type of stress while receiving pregnancy care. That means that there is a preventable higher risk for pregnancy and birth complications caused by increased stress during pregnancy and daily life. These complications include macrosomia, pre-term birth, and low-birth weight. Preventable stress, also called minority stress, links to this increase in health problems outside of pregnancy as well. Since minority stress influences patient/parents' health, it is also called a risk or vulnerability. Resilience, or the ability to overcome stress and discrimination, can sometimes help improve health outcomes. However, little is known about which types of resilience can be helpful for LGBTQIA+ parents given their unique experiences of minority stress.

The planned observational study will investigate the ways in which experiences of minority stress and resilience in pregnancy care are associated with parent health and birth outcomes. A sample of pregnant patients (N=800) from maternity wards in and around London will take part through an online panel survey (completed twice) that will be linked to each patient/participant's electronic health records to create a quantitative dataset. Participant recruitment will focus on LGBTQIA+ pregnant patients (n=200). A matched comparison sample of cisgender, heterosexual pregnant patients (n=600) will also be recruited to take part from the same maternity. From the full sample, patient/parents from University College London Hospital will be invited to complete an at-home journal activity which will provide qualitative data on their experiences of minority stress and resilience. This smaller group (n=30). Results from this study can be used to inform LGBTQIA+ guidelines, training, and help make reproductive healthcare more inclusive.

Conditions

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Pregnancy Related

Keywords

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LGBTQIA+ Reproduction Resilience Vulnerability Risk Neonatal Health Parent Health Allostatic Load

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Gestational parents

The study is composed of a sample of LGBTQIA+ and cisgender, heterosexual parents who are receiving antenatal care at the participating hospitals.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Legal adult of reproductive age (18-49)
* Identifies as a lesbian, gay, bisexual, queer, nonbinary, intersex, and/or transgender (or cisgender and heterosexual for comparison sample)
* Currently pregnant and receiving antenatal care at one of the study sites

Exclusion Criteria

* Any pregnant persons under the age of 18
* Pregnant individuals using sites locations for Urgent care, A\&E, non-antenatal services only

Minimum Eligible Age

18 Years

Maximum Eligible Age

49 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David M Frost, PhD

Role: STUDY_CHAIR

University College, London

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IRAS 264198

Identifier Type: OTHER

Identifier Source: secondary_id

EDGE 124858

Identifier Type: -

Identifier Source: org_study_id

Legacies and Futures: Measuring Roles of Resilience and Vulnerability in Pregnancy and Birth Outcomes

Study Results

Basic Information

Brief Summary

Detailed Description

Conditions

Keywords

Study Design

Study Groups

Gestational parents

Eligibility Criteria

Inclusion Criteria

Exclusion Criteria

Sponsors

UCL, Bloomsbury and East London (UBEL) Doctoral Training Partnership

Economic and Social Research Council, United Kingdom

University College London Hospitals

King's College Hospital NHS Trust

University Hospitals Sussex NHS Foundation

Homerton University Hospital

Barts & The London NHS Trust

The Whittington Hospital NHS Trust

Guy's and St Thomas' NHS Foundation Trust

West Hertfordshire Hospitals NHS Trust

Kingston Hospital NHS Trust

Royal Free Hospital NHS Foundation Trust

Imperial College Healthcare NHS Trust

Epsom and St Helier University Hospitals NHS Trust

Lewisham and Greenwich NHS Trust

St George's University Hospital NHS Foundation Trust

University College, London

Responsible Party

Principal Investigators

David M Frost, PhD

Locations

King's College Hospital NHS Foundation Trust

Kingston Hospital NHS Foundation Trust

Barts Health NHS Trust

Homerton University Hospital NHS Foundation Trust

Whittington Health NHS Trust

Royal Free London NHS Foundation Trust

Lewisham and Greenwich NHS Trust

St George's University Hospitals NHS foundation Trust

University College London Hospital NHS Foundation Trust

Imperial College Healthcare NHS Trust

Guy's and St Thomas' NHS Foundation Trust

Epsom and St Helier University Hospitals NHS Trust

West Hertfordshire Teaching Hospitals NHS Trust

University Hospitals Sussex NHS Foundation

Countries

Other Identifiers

IRAS 264198

EDGE 124858