PEDIATRICS Vol. 107 No. 2 February 2001, p. e19

ELECTRONIC ARTICLE:
Abused Boys, Battered Mothers, and Male Involvement in Teen Pregnancy

Received Jul 7, 2000; accepted Sep 28, 2000.

Robert F. Anda^*, Vincent J. Felitti, Daniel P. Chapman^*, Janet B. Croft^*, David F. Williamson^*, John Santelli^*, Patricia M. Dietz^*, and James S. Marks^*

From the ^* National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and the  Department of Preventive Medicine, Southern California Permanente Medical Group, Kaiser Permanente, San Diego, California.

Background.  The relationship between boyhood exposure to physical abuse, sexual abuse, or to a battered mother and subsequent risk of impregnating a teenage girl has not previously been examined.

Methods.  In a retrospective cohort study set in a primary care clinic for adult members of a large health maintenance organization, questionnaire responses from 4127 men were analyzed. Respondents provided the age of the youngest female whom they had impregnated, their own ages at the time, and information regarding childhood exposure to physical or sexual abuse and battered mothers. We calculated the prevalence and adjusted odds ratio (OR) for having impregnated a teenage girl according to these 3 adverse childhood experiences, regardless of the male's age at the time of impregnation. Using logistic regression, ORs were adjusted for the male's age at time of survey, race, and education.

Results.  Nineteen percent of the men reported that they had ever impregnated a teenage girl. During childhood, 32% of respondents had been physically abused, 15% sexually abused, and 11% had battered mothers. Compared with respondents reporting no abuse, frequent physical abuse or battering of mothers increased the risk of involvement in teen pregnancy by 70% (OR: 1.7; 95% confidence interval [CI]: 1.2-2.5) and 140% (OR: 2.4; 95% CI: 1.1-5.0), respectively. Sexual abuse as a boy at age 10 years or younger increased the risk of impregnating a teenage girl by 80% (OR: 1.8; 95% CI: 1.3-2.4); sexual abuse with violence increased the risk by 110% (OR: 2.1; 95% CI: 1.2-3.4). We found a dose-response relationship between the number of types of exposures and the risk of impregnating a teenage girl; men who reported all 3 types of exposures were more than twice as likely to have been involved than those with no exposures (OR: 2.2; 95% CI: 1.4-3.5).

Conclusions.  Boyhood exposure to physical or sexual abuse or to a battered mother is associated with an increased risk of involvement in a teen pregnancyduring both adolescence and adulthood. Because these exposures are common and interrelated, boys and adult men who have had these experiences should be identified via routine screening by pediatricians and other health care providers and counseled about sexual practices and contraception. Such efforts may prevent teen pregnancy and the intergenerational transmission of child abuse and domestic violence.  Key words:  adolescent pregnancy, child abuse, domestic violence.

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