Data on 3,128 girls in grades eight, 10 and 12 who participated in the 1992 Washington State Survey of Adolescent Health Behaviors were used to analyze the association of a self-reported history of sexual abuse with teenage pregnancy and with sexual behavior that increases the risk of adolescent pregnancy. In analyses adjusting for grade level, respondents who had been sexually abused were 3.1 times as likely as those who had not been abused to say they had ever been pregnant; in multivariate analyses, respondents who had experienced abuse were 2.3 times as likely as others to have had intercourse but were not more likely than other sexually active respondents to have been pregnant. However, those with a history of sexual abuse were more likely to report having had intercourse by age 15 (odds ratio, 2.1), not using birth control at last intercourse (2.0) and having had more than one sexual partner (1.4). Thus, an association between sexual abuse and teenage pregnancy appears to be the result of high-risk behavior exhibited by adolescent girls who have been abused.
PIP: The association between a self-reported history of child sexual abuse and adolescent pregnancy was investigated in the 1992 Washington State (US) Survey of Adolescent Health Behaviors. Enrolled in the study were 3128 girls from 70 school districts in grades 8, 10, and 12. In these 3 grades, the prevalence of sexual abuse was 18%, 24%, and 28%, respectively. Sexual abuse was reported by 48% of students who had been pregnant at least once and 21% of those who had never been pregnant. After adjustment for grade level, girls who had been sexually abused were 3.1 times as likely to have ever been pregnant than those without such a history. In multivariate analysis controlled for other risk factors, sexually abused girls were 2.3 times more likely than others to have had sexual intercourse, but were not more likely than other sexually active girls to have been pregnant. However, those with a history of sexual abuse were more likely to have had intercourse by age 15 years (odds ratio (OR), 2.1), not to have used birth control at last intercourse (OR, 2.0), and to have had more than 1 sexual partner (OR, 1.4). These findings suggest that the association between sexual abuse and adolescent pregnancy results from the high-risk sexual behaviors of girls with an abuse history. Although the private nature of child sexual abuse impedes efforts at primary prevention, school counselors are urged to discuss child sexual abuse openly and target self-reported victims for pregnancy prevention.