Is there a causal link between maltreatment and adolescent pregnancy? A literature review.

CONTEXT Despite a sizable amount of research addressing the relationship between violence and women's reproductive health, it has not been shown whether there is sufficient evidence of a causal link between childhood maltreatment and subsequent adolescent pregnancy. METHODS Three databases (Medline, PsychiNFO and SocioFile) were searched for studies published between 1980 and 2000 relating maltreatment and adolescent pregnancy. The review was limited to empirical studies; theoretical articles and those with no women who were aged 21 or younger during the research period or when they experienced maltreatment were excluded. RESULTS Fifteen articles on the topic were found All were published after 1989; all but one were cross-sectional, were retrospective and relied on recall. All of the studies dealt with sexual maltreatment, either alone or in combination with other types of maltreatment; few covered emotional abuse or neglect. The studies lacked consistent definitions of the various types of maltreatment. Only one examined adolescent mothers' relationships with men, and none examined relationships with perpetrators. Few dealt with racial and ethnic differences related to violence. All lacked a specific theoretical approach. Ten of the studies supported a link between maltreatment and adolescent pregnancy, and five eitherdid not support a link or qualified the relationship. Substance abuse, poor mental health and promiscuity were among the mediating variables examined. CONCLUSIONS Because recent studies have reached conflicting findings, had methodological weaknesses and lacked theoretical grounding, whether a causal link exists between maltreatment and adolescent pregnancy remains an unanswered question.