O4315: Needs of LGBTQ+ parents in the NICU

Background: Specific challenges faced by LGBTQ+ parents navigating the Neonatal Intensive Care Unit (NICU) remain relatively understudied and underrepresented. Our aim was to perform a scoping review of the literature to understand what has been studied and to identify gaps in research examining the experiences of LGBTQ+ parents, both birthing and non-birthing, in the NICU.

Methods: A PubMed search was conducted, limited to articles published in English over 15 years (1/1/2007 to 12/31/2022) using the some search terms: "gay+NICU," "gay+newborn," "lesbian+newborn," "LGBTQ+newborn," "transgender+newborn," "adoptive parent+newborn," "surrogate parent+NICU," "surrogate parent+newborn," and "same-sex+NICU." Initial screening identified articles addressing parental needs or experiences within NICU or newborn nursery settings. Those articles were further analyzed for study of: parent type (birthing/non-birthing/both), LGBTQ+ parent, study type, study location, and NICU aspect studied.

Results: Search terms identified 999 unique articles when 298 duplicates were removed. Of these 999 articles, only 29 articles met the criteria of studying the needs or experiences of LGBTQ+ parents in the NICU or newborn nursery. Of these 29 articles, 17 represented research within North America (14 in US, 3 in Canada), 8 in Europe, and 1 in Africa. Articles represented diverse study types: qualitative studies (4), cross-sectional surveys (2), quasi-experimental studies (2), and review articles (6). The six articles specifically addressing LGBTQ+ parents in the NICU examined: shared decision making (2), family centered care (2), communication (1) and neonatal death (1). The remaining articles examined other parenting aspects such as transmasculine lactation (4), adoption (2), pregnancy (3), and surrogacy (1).

Conclusion: Our review highlights gaps in research regarding the needs and experiences of LGBTQ+ parents in the NICU. Of the articles identified, only a small fraction (6 out of 29) specifically addressed LGBTQ+ parents in the NICU. We have reported findings from only a subset of a broader scoping review underway, examining what is known about the needs and experiences of birthing and non-birthing parents in the NICU. Whether and how LGBTQ+ parents are included in studies in the broader search will further allow identification of gaps with the goal of planning future studies for supporting diverse family structures in the NICU to inform health equity efforts.