Childhood sexual abuse is a common antecedents of adolescent pregnancy. We studied the pregnancies of 127 poor, black, 12- to 18-year-olds; 42 (33%) of whom reported that they had been physically or sexually abused prior to conception. We hypothesized that during pregnancy: (a) Previously abused adolescents report more stress and depression and less adequate social support than do nonabused adolescents; and (b) Previously abused adolescents obtain less prenatal care, gain less weight, engage in more substance abuse, and give birth to smaller babies than do nonabused adolescents. Consistent with the first study hypothesis, we found that abused adolescents scored significantly higher on stress and depression scales and rated their families as less supportive than did nonabused adolescents. Although there were no group differences in the rate of weight gain or the quantity of prenatal care obtained during pregnancy, abused adolescents were more likely to report substance use during pregnancy and gave birth to significantly smaller, (2,904 +/- 676 vs. 3,198 +/- 443 grams; p = .01), less mature (38.0 +/- 3.4 vs. 39.1 +/- 1.7 weeks; p = .05) infants. Our finding demonstrate the importance of asking pregnant adolescents about abuse.