Sexual Identity and Birth Outcomes: A Focus on the Moderating Role of Race-ethnicity

Bethany G. Everett, Aubrey Limburg, Brittany M. Charlton, Jae M. Downing, Phoenix A. Matthews

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Race-ethnic disparities in birth outcomes are well established, and new research suggests that there may also be important sexual identity disparities in birth weight and preterm birth. This study uses the National Longitudinal Study of Adolescent to Adult Health and is the first to examine disparities in birth outcomes at the intersection of race-ethnicity and sexual identity. We use ordinary least sqaures and logistic regression models with live births (n = 10,318) as the unit of analysis clustered on mother ID (n = 5,105), allowing us to adjust for preconception and pregnancy-specific perinatal risk factors as well as neighborhood characteristics. Results show a striking reversal in the effect of lesbian or bisexual identity on birth outcomes across race-ethnicities: For white women, a bisexual or lesbian identity is associated with better birth outcomes than their white heterosexual counterparts, but for Black and Latina women, it is associated with worse birth outcomes than their heterosexual peers.

Original languageEnglish (US)
Pages (from-to)183-201
Number of pages19
JournalJournal of health and social behavior
Issue number2
StatePublished - Jun 2021


  • health inequality
  • maternal health
  • pregnancy outcomes
  • race-ethnicity
  • sexual orientation

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health


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