Pregnancy Related Clinical Trial
Official title:
Legacies and Futures: Gestational Parents' Experiences With Vulnerability and Resilience as it Influence Parent and Neonatal Health
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.
Status | Recruiting |
Enrollment | 800 |
Est. completion date | March 2024 |
Est. primary completion date | March 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 49 Years |
Eligibility | 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 |
Country | Name | City | State |
---|---|---|---|
United Kingdom | King's College Hospital NHS Foundation Trust | Brixton | |
United Kingdom | Kingston Hospital NHS Foundation Trust | Kingston Upon Thames | |
United Kingdom | Barts Health NHS Trust | London | |
United Kingdom | Guy's and St Thomas' NHS Foundation Trust | London | |
United Kingdom | Homerton University Hospital NHS Foundation Trust | London | |
United Kingdom | Imperial College Healthcare NHS Trust | London | |
United Kingdom | Lewisham and Greenwich NHS Trust | London | |
United Kingdom | Royal Free London NHS Foundation Trust | London | |
United Kingdom | St George's University Hospitals NHS foundation Trust | London | |
United Kingdom | University College London Hospital NHS Foundation Trust | London | |
United Kingdom | Whittington Health NHS Trust | London | |
United Kingdom | Epsom and St Helier University Hospitals NHS Trust | Sutton | |
United Kingdom | West Hertfordshire Teaching Hospitals NHS Trust | Watford | |
United Kingdom | University Hospitals Sussex NHS Foundation | Worthing |
Lead Sponsor | Collaborator |
---|---|
University College, London | Barts & The London NHS Trust, Economic and Social Research Council, United Kingdom, Epsom and St Helier University Hospitals NHS Trust, Guy's and St Thomas' NHS Foundation Trust, Homerton University Hospital, Imperial College Healthcare NHS Trust, King's College Hospital NHS Trust, Kingston Hospital NHS Trust, Lewisham and Greenwich NHS Trust, Royal Free Hospital NHS Foundation Trust, St George's University Hospital NHS Foundation Trust, The Whittington Hospital NHS Trust, UCL, Bloomsbury and East London (UBEL) Doctoral Training Partnership, University College London Hospitals, University Hospitals Sussex NHS Foundation, West Hertfordshire Hospitals NHS Trust |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Primary Scientific Aim - Parental Health | The outcome measured for impact from resilience and vulnerability is parent health as allostatic load (as health data from routine antenatal check-ups). Scales will be composited into intrapersonal stressors (i.e., felt stigma, level of outness), interpersonal stressors (i.e., homelessness & child welfare, stressful life events/stress, everyday discrimination, chronic strains, police interactions), structural stressors (i.e., household social vulnerability index, deprivation score), intrapersonal resilience (i.e., coping, social support), interpersonal resilience (i.e., patient experience scale, shared decision-making, emotional reactivity), and structural resilience (i.e., community connectedness, civic engagement). | through study completion, up to 10 months | |
Primary | Primary Scientific Aim - Infant Health | The composite for parent health (i.e. allostatic load from Outcome 1) will be assessed to see if there is an impact on infant health (a composite of head circumference, gestational length, birth weight, birth length, Apgar score). | through study completion, up to 10 months | |
Secondary | Secondary Scientific Aim - Understanding additional stressors and resilience | Qualitative journals will be used to assess for additional stressors and resilience resources to ascertain if there are measures that have not been accounted for within the quantitative measures. These are presently unknown, as the point of the measure is to uncover these dimensions of the constructs of resilience and vulnerability. | through study completion, up to 10 months | |
Secondary | Secondary Scientific Aim - Contextualising resilience and vulnerability | The same qualitative journals in outcome 3 will also provided narratives about the experiences of parents with extreme resilience and vulnerability scores. The assessment of these narratives will be done to help contextualise the presence of extreme scores for parents receiving antenatal care at UCLH. The contents of these narratives collectively will be reported within the final findings alongside the quantitative data, as well as will be quoted specifically when relevant. | through study completion, up to 10 months |
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