Original article
More Than Poverty: The Effect of Child Abuse and Neglect on Teen Pregnancy Risk

https://doi.org/10.1016/j.jadohealth.2015.05.004Get rights and content

Abstract

Purpose

The purpose of the study was to compare risk for teen pregnancies between children living in poverty with no child protective services (CPS) report history and those in poverty with a history of CPS report.

Methods

Children selected from families in poverty, both with and without CPS report histories were prospectively followed from 1993 to 2009 using electronic administrative records from agencies including CPS, emergency departments, Medicaid services, and juvenile courts. A total of 3,281 adolescent females were followed until the age of 18 years.

Results

For teens with history of poverty only, 16.8% had been pregnant at least once by the age of 17 years. In teens with history of both poverty and report of child abuse or neglect, 28.9% had been pregnant at least once by the age of 17 years. Although multivariate survival analyses revealed several other significant factors at the family and youth services levels, a report of maltreatment remained significant (about a 66% higher risk).

Conclusions

Maltreatment is a significant risk factor for teen pregnancy among low income youth even after controlling for neighborhood disadvantage, other caregiver risks and indicators of individual emotional and behavioral problems.

Section snippets

Study sample

Data for this analysis were drawn from a larger longitudinal administrative data study that tracked a range of service system involvement and outcomes for children with histories of poverty or poverty and maltreatment during childhood. The larger study consisted of three groups of participants (one child randomly selected per family) born 1980–1994: those with a report of CAN, children with families who receive Aid to Families with Dependent Children (AFDC), and children with both CAN and AFDC

Results

The final sample consisted of 3,281 young women; of whom, 1,343 (40.9%) had a history of poverty only, and 1938 (59.1%) had histories of both CAN and poverty. Among subjects with a history of at least one report of abuse or neglect, 28.9% had a record of at least one pregnancy from ages 10 to 17 years compared with 16.8% for the poverty only group. This difference remained significant in bivariate analyses controlling for time from birth to the end of the study period (see Table 1). Mean age at

Discussion

This study contributes to our understanding of why some youth continue to face higher pregnancy rates while the general population pregnancy rate declines. With a growing body of literature linking adversity in childhood to poor adult outcomes, studies such as this one that determines relative risks of adversity exposures are important. This study adds to the understanding of adolescent pregnancy risk by controlling for poverty as a confounder. The prospective data findings that even a single

Funding Sources

This study was supported by Centers for Disease Control and Prevention (CE001190) and National Institute of Mental Health (2R01 MH061733).

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      Adolescent girls involved with CPS and presenting clinical levels of trauma symptoms were up to seven times more likely to engage in risky sexual behaviors than those without clinically significant trauma symptoms (Cavanaugh, 2013; Taussig & Talmi, 2001). A number of studies have demonstrated an association between the risk of early motherhood and the challenges associated with being a young woman who was in contact with CPS, such as childhood maltreatment, placement instability, or risky sexual behaviors (Font et al., 2019; Garwood et al., 2015; King, 2017; ; King & Van Wert, 2017; Noll et al., 2019; Noll & Shenk, 2013; Shpiegel, Cascardi, & Dineen, 2017). However, previous studies on early motherhood in young women who had contact with CPS have had some limitations.

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