A new Cincinnati Children's Hospital Medical Center study, published in the eFirst pages of the journal
, shows that teen childbirth rates are more than 20 percent for abused and neglected teens. This compares to the national teen childbirth rate of approximately 4 percent.
The finding holds true even after taking into account such factors as race, family income and whether the family was a one- or two-parent household.
"Teen victims of sexual abuse may have distinct approaches to sex and sexual activity that can be attributed to traumatic sexualization," says Jennie Noll, PhD, director of research in Behavioral Medicine and Clinical Psychology at Cincinnati Children's and the study's lead author. "On the other hand, neglect is an act of omission in which parents and caregivers fail to provide the needed care and opportunities for promoting safe and normal development. As with the general teen population, primary prevention programs targeting sexual activity will help mitigate the risk of childbirth for maltreated adolescents."
In this first ever prospective study of teen pregnancy (one that follows a group over time), Dr. Noll studied teen girls between 14 and 17, assessing them annually through the age of 19 to track their sexual activities, possible pregnancy and motherhood. About half of the teenagers in the study were recruited from child protective service agencies for having been abused or neglected within the past 12 months. The other half consisted of "comparison" teenage girls who had not experienced abuse or neglect but were similar in terms of age, income, minority status and family constellation (one- or two-parent households).
Fifty-four of those who had been abused or neglected had children, representing a teen childbirth rate of 20.3 percent. Sixteen of those in the comparison group had children, representing a teen childbirth rate of 9.4 percent.
"Although the comparison group had childbirth rates greater than twice the national rate of 4 percent, these girls were selected to be demographically similar to the abused sample, so they were from relatively low income, inner city neighborhoods - places where teen childbirth rates are often higher than the national average," says Dr. Noll.
While teen birth rates in the United States have been declining since they peaked in 1991, the US continues to have one of the highest teen birth rates among industrialized nations. One explanation for this, according to Dr. Noll, is that there are risk factors for teen pregnancy and childbirth not addressed in current prevention efforts - particularly for teen girls entering protective services due to abuse or neglect.
"Because victims of maltreatment are processed through child protective service agencies, caseworkers have a golden opportunity to educate these teen girls about the risk for, and consequences of, teen childbirth," says Dr. Noll.
The median age of all participants in Dr. Noll's study initial assessment was 15.26 years, median household income was $30,000 to $39,000, and 57 percent were from single parent households. Forty-eight percent were black and eight percent were biracial or multiracial.