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PEDIATRICS Vol. 101 No. 4 April 1998, pp. 620-624

Does Child Abuse Predict Adolescent Pregnancy?

Received Dec 20, 1996; accepted Jul 23, 1997.

Kevin Fiscella*, Harriet J. KitzmanDagger , Robert E. Cole§, Kimberly J. SidoraDagger , and David Oldsparallel

From the * Department of Family Medicine, University of Rochester School of Medicine; the Dagger  University of Rochester School of Nursing; the § Department of Psychiatry, University of Rochester School of Medicine, Rochester, New York; and the parallel  Department of Pediatrics, the University of Colorado at Denver, Denver, Colorado.

Objective.  To determine whether sexual and nonsexual childhood abuse are risk factors for early adolescent sexual activity and pregnancy.

Design.  Cross-sectional study.

Setting.  Prenatal clinic within an inner-city teaching hospital from June 1990 to August 1991.

Population.  One thousand twenty-six primiparous, African-American women enrolled in a randomized clinical trial of nurse home visitation.

Main Outcome Measures.  Four measures of child abuse were used: sexual abuse, incidents of physical abuse, any major physical abuse, and emotional abuse. The outcome measures were age of first consensual coitus and age of first pregnancy.

Results.  After adjustments for household income, parental separation, urban residence, age of menarche, and teen smoking, sexual abuse during childhood was associated with younger age at first coitus (7.2 months; 95% confidence interval [CI], 2.6 to 11.7 months) and younger age at first pregnancy (9.7 months; 95% CI, 3.0 to 16.3 months). Incidents of physical abuse showed minimal effect on age at first coitus (1.2 days per incident; 95% CI, 0.5 to 1.9 days) and no effect on age of first pregnancy. A history of major physical abuse or emotional abuse showed no effect on age of first coitus or first pregnancy.

Conclusion.  Child sexual abuse, but not child physical or emotional abuse, seems to be a risk factor for earlier pregnancy among African-American adolescents.

Key words: child abuse, sexual abuse, adolescent pregnancy, sexual activity.


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