Poster Session 4
Justin S. Brandt, MD (he/him/his)
Associate Professor, Division Director, Fellowship Program Director
NYU Langone Health
New York, New York, United States
Rebecca J. Baer, MS
Research Analyst
University of California San Francisco School of Medicine
San Francisco, California, United States
Scott P. Oltman, MS
Epidemiologist
University of California San Francisco School of Medicine
San Francisco, California, United States
Diana S. Abbas, MD
Ob/Gyn Resident
NYU Grossman School of Medicine
New York, New York, United States
Marra Ackerman, MD
NYU Langone Health
New York, New York, United States
Allison Deutch, MD
NYU Langone Health
New York, New York, United States
Dana R. Gossett, MD, MSCI
Professor and Chair, Department of Obstetrics and Gynecology
NYU Langone Health
New York, New York, United States
Laura L. Jelliffe-Pawlowski, PhD
Epidemiology and Biostatistics Professor
NYU Langone Health
New York, New York, United States
To evaluate the risk of ischemic placental disease (IPD), severe morbidity (SM), and preterm delivery (PTD) among individuals who identify as non-mother birthing people, presumably transgender men and gender diverse people assigned female sex at birth.
Study Design:
We performed a cross-sectional study of singleton live births in California (2019-2021). Birth certificates were linked to hospital discharge and neonatal records. Birthing parent identity was based on birth certificates, in which birthing people self-identify as mother, father, or parent. The primary outcomes were IPD (hypertensive disorders of pregnancy, placental abruption, and small for gestational age birth), composite SM based on the CDC definition, and PTD < 37 weeks gestation. Outcomes were determined by ICD-10 codes. The risk of outcomes was calculated for non-mother versus mother birthing people using Poisson regression models.
Results:
There were 1,298,307 singleton live births in California from 2019-2021, including 1,065,714 linked hospital and neonatal records with birthing person identities. 898 (0.08%) people had non-mother birthing identities, of whom 9.2% were age >40 years, 24.9% had BMI >30 kg/m2, 13.1% had pregestational diabetes, and 2.2% had chronic hypertension. Compared to mother birthing people, non-mother birthing people had similar rates of adequate prenatal care as defined by Kotelchuck (71.9% vs. 70.1%), but higher rates of cesarean delivery (30.9% vs. 24.9%) and pregnancies conceived with assisted reproduction (17.3% vs. 1.7%). The risk of IPD was similar between the groups, but the risks of SM (RR 1.69, 95% CI 1.20, 2.38) and preterm birth (RR 1.30, 95% CI 1.07, 1.58) were increased among non-mother birthing people. The risks are further described in the Table.
Conclusion: In this study of singleton live births in California, non-mother birthing people had similar rates of adequate prenatal care, but were at increased risk for SM and PTD, though not at increased risk for IPD, compared to mother birthing people. These disparate risks may reflect the impact of minority stress and warrant further evaluation.
