Past physical abuse is significantly correlated with pregnancy as an adolescent

The Association of Teen Pregnancy and Violence: A Multilevel Study in Colombia

Background

Colombia has a high teen pregnancy (TP) rate. In 2018, one in five pregnancies was from teen mothers between 10 and 19 years of age. While TP rates are declining globally, Colombia's TP rate decline has been particularly low, despite sexual education and contraception campaigns. Other factors must be studied to prevent TP. Colombia has a long history of violence. We aim to assess whether there is a relationship between TP and exposure to violence in Colombia.

Methods

Data from the Colombian Demographic and Health Survey 2015 and the Colombian National Department of Statistics were analyzed for association between TP and sexual violence, physical violence, physical punishment as a child, and community violence. Univariate, bivariate, multivariate, and multilevel binary logistic regression models were calculated using SPSS v.25 and HLM v.7.

Results

Fifteen percent of teens were pregnant. Emotional violence was reported by 47%, sexual harassment by 27%, physical violence by 17%, physical punishment as a child by 7%, and unwanted sex by 2%. Unwanted sex (odds ratio [OR]: 3.18, 95% confidence interval [95% CI]: 1.96-5.16), sexual harassment (OR: 2.43, 95% CI: 1.89-3.14), and physical punishment (OR: 20.30, 95% CI: 7.96-22.81) were associated with adolescent pregnancy. In unadjusted models, emotional violence was associated (OR: 1.22, 95% CI 1.06-1.40) and community violence showed a tendency (OR: 1.24, 95% CI: 0.99-1.55). Physical violence was not associated.

Conclusions

Violence exposure and particularly physical punishment, unwanted sex and sexual harassment were associated with TP incidence and should be considered risk factors for TP.

Early Childbirth Among Foster Youth: A Latent Class Analysis to Determine Subgroups at Increased Risk

CONTEXT

Research has documented elevated rates of early childbirth among adolescents who have spent time in foster care, and a better understanding is needed of the characteristics of vulnerable individuals and the circumstances of their time in care.

METHODS

California birth records for 1999-2010 were probabilistically linked to state child welfare service records spanning the same date range to identify females aged 12-19 who had spent time in foster care and had had a first birth before age 20. Latent class analysis was used to identify subgroups based on age at most recent entry into care, length of this stay and three indicators of placement instability. The probability of a first birth being related to class membership was assessed as a distal outcome, and differences across classes were assessed using chi-square tests.

RESULTS

Four distinct classes of foster youth were identified: Later Entry/High Instability (20% of individuals), Later Entry/Low Instability (43%), Earlier Entry/High Instability (12%) and Earlier Entry/Low Instability (25%). The probability of a first childbirth ranged from 31% (class 1) to 15% (class 4); classes 2 and 3 experienced moderate risk (23% and 24%, respectively). Two groups were further characterized by high rates of reentry into care, with 56% of class 1 and 41% of class 3 individuals experiencing more than one episode in care.

CONCLUSIONS

Identifiable subgroups of female foster youth are at heightened risk of early childbirth and may benefit from early intervention, enhanced support and access to reliable, ongoing sexual and reproductive health care.

Predictors of Early Childbirth Among Female Adolescents in Foster Care

PURPOSE

Placement into foster care is driven by a number of factors, many of which are associated with adolescent childbirth. Yet, there are few studies that identify the experiences and characteristics that predict adolescent childbirth among girls who spend time in foster care.

METHODS

A longitudinal, population-based data set was constructed by probabilistically matching California child protective service records for female foster youth to maternal information available on vital birth records for children born between 2001 and 2010. Rates of childbirth among girls in foster care after their 10th birthday were generated. Chi-square tests assessed differences and survival models were specified to determine the rate of childbearing across key characteristics.

RESULTS

Among the 30,339 girls who spent time in foster care as adolescents, 18.3% (5,567) gave birth for the first time before their 20th birthday. At a bivariate level, significant differences (p < .001) in birth rates were observed across demographic characteristics, maltreatment history, and foster care placement experiences. In the fully adjusted survival model, the highest birth rates were observed among girls who entered care between ages 13 and 16 years; had been in care for relatively short periods of time; lived in congregate care at the estimated date of conception; had a history of running away; and were Latina, black, or Native American.

CONCLUSIONS

The results suggest that there are identifiable risk factors associated with early childbirth among girls in foster care, which can help determine the timing and location of reproductive health services to minimize unintended pregnancy and maximize adolescent health and well-being.

First Births to Maltreated Adolescent Girls: Differences Associated With Spending Time in Foster Care

Few studies have examined early parenting among girls receiving child welfare services (CWS) or disentangled the relationship between maltreatment, spending time in foster care, and adolescent childbirth. Using population-based, linked administrative data, this study calculated birth rates among maltreated adolescent girls and assessed differences in birth rates associated with spending time in foster care. Of the 85,766 girls with substantiated allegations of maltreatment during adolescence, nearly 18% subsequently gave birth. Among girls who spent time in foster care, the proportion was higher (19.5%). Significant variations ( p < .001) were observed in the rate of childbirth across demographic characteristics and maltreatment experiences. When accounting for all of the covariates, spending time in foster care was associated with a modestly higher rate of a first birth (Hazard Ratio [HR] = 1.10; 95% confidence interval = [1.06, 1.14]). While age at first substantiated allegation of maltreatment and race/ethnicity were significant predictors of adolescent childbirth, specific maltreatment experiences were associated with minimal or no differences in birth rates. The findings of this study suggest that the experience of spending time in care may not be a meaningful predictor of giving birth as a teen among CWS-involved adolescent girls and highlight subgroups of this population who may be more vulnerable to early childbirth.

Factors Associated with Pregnancy among Incarcerated African American Adolescent Girls

The purpose of this study was to examine the social and behavioral factors associated with pregnancy history among a sample of African American adolescent girls recruited from a short-term juvenile detention center in order to better understand the needs of this vulnerable population. Data were collected from a sample of 188 detained African American, 13-17-year-old girls in Atlanta, Georgia, who participated in a larger HIV prevention study. An audio computer-assisted self-interviewing survey was completed by participants to obtain information on socioecological factors to include individual, parental/familial, sexual risk, psychosocial, and substance use factors. Among the 188 participants, 25.5 % reported a history of pregnancy. A multivariable logistic regression model showed that girls with a history of pregnancy were more likely to live in a household receiving government aid, use hormonal contraceptives at last sex, participate in sex trading, have casual sex partners, have condomless sex in the past 90 days, and have a history of physical abuse. Girls with no history of pregnancy were more likely to have been incarcerated at least twice and to have previously used alcohol. Detention-based interventions and pregnancy prevention programs for this vulnerable population may benefit by addressing factors related to sexual behavior and development, substance use, individual background, and psychosocial health.

[Sexual Abuse and Neglect Situations as Risk Factors for Adolescent Pregnancy]

BACKGROUND

In Colombia, one out of five women between the ages of 15 and 19 years have been pregnant. Almost two-thirds (64%) of these pregnancies were unplanned.

OBJECTIVES

To examine the socio-demographic, psychosocial and clinical risk factors associated with adolescent pregnancy.

METHODS

An analytical prevalence study was performed using secondary data from the First Demographic Study of Mental Health in Medellin, Colombia. Female adolescents between 13 and 19 years of age were included in the study. The population was evaluated using the Composite International Diagnosis Interview, a structured interview developed by the World Health Organization, which establishes diagnoses according to the DSM-IV and ICD-10 criteria.

RESULTS

A sample of 499 female adolescents was obtained, in which 135 adolescent pregnancies were identified, representing a prevalence of 21.5%. The large majority (84.4%) were between 16 and 19 years old. The median age was 17 years, with an interquartile range of 2 years. Almost two-thirds (61.2%) of female adolescents had initiated sexual activity at the age of 15 or later. Almost one-third (31.9%) reported being physically abused during childhood, and 6.7% sexually abused. Of those who were pregnant, 66.7% reported previous sexual abuse. A bivariate analysis showed that sexual abuse (OR=7.68), childhood negligence (OR=4.33), and having a partner (OR=6.31) were factors associated with an adolescent pregnancy.

CONCLUSIONS

Negligence and sexual abuse in childhood and adolescence can be prevented, and adolescent pregnancies can be decreased. This finding has important implications for clinical management and prognosis, and requires public preventive policies.

Adolescent Pregnancy Guidelines

OBJECTIVE

To describe the needs and evidence-based practice specific to care of the pregnant adolescent in Canada, including special populations.

OUTCOMES

Healthy pregnancies for adolescent women in Canada, with culturally sensitive and age-appropriate care to ensure the best possible outcomes for these young women and their infants and young families, and to reduce repeat pregnancy rates.

EVIDENCE

Published literature was retrieved through searches of PubMed and The Cochrane Library on May 23, 2012 using appropriate controlled vocabulary (e.g., Pregnancy in Adolescence) and key words (e.g., pregnancy, teen, youth). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Results were limited to English or French language materials published in or after 1990. Searches were updated on a regular basis and incorporated in the guideline to July 6, 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, national and international medical specialty societies, and clinical practice guideline collections.

VALUES

The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). BENEFITS/HARMS/COSTS: These guidelines are designed to help practitioners caring for adolescent women during pregnancy in Canada and allow them to take the best care of these young women in a manner appropriate for their age, cultural backgrounds, and risk profiles.

RECOMMENDATIONS

1. Health care providers should adapt their prenatal care for adolescents and offer multidisciplinary care that is easily accessible to the adolescent early in the pregnancy, recognizing that adolescents often present to care later than their adult counterparts. A model that provides an opportunity to address all of these needs at one site may be the preferred model of care for pregnant adolescents. (II-1A) 2. Health care providers should be sensitive to the unique developmental needs of adolescents through all stages of pregnancy and during intrapartum and postpartum care. (III-B) 3. Adolescents have high-risk pregnancies and should be managed accordingly within programs that have the capacity to manage their care. The unique physical risks of adolescent pregnancy should be recognized and the care provided must address these. (II-1A) 4. Fathers and partners should be included as much as possible in pregnancy care and prenatal/infant care education. (III-B) 5. A first-trimester ultrasound is recommended not only for the usual reasons for properly dating the pregnancy, but also for assessing the increased risks of preterm birth. (I-A) 6. Counselling about all available pregnancy outcome options (abortion, adoption, and parenting) should be provided to any adolescent with a confirmed intrauterine gestation. (III-A) 7. Testing for sexually transmitted infections (STI) (II-2A) and bacterial vaginosis (III-B) should be performed routinely upon presentation for pregnancy care and again in the third trimester; STI testing should also be performed postpartum and when needed symptomatically. a. Because pregnant adolescents are inherently at increased risk for preterm labour, preterm birth, and preterm pre-labour rupture of membranes, screening and management of bacterial vaginosis is recommended. (III-B) b. After treatment for a positive test, a test of cure is needed 3 to 4 weeks after completion of treatment. Refer partner for screening and treatment. Take the opportunity to discuss condom use. (III-A) 8. Routine and repeated screening for alcohol use, substance abuse, and violence in pregnancy is recommended because of their increased rates in this population. (II-2A) 9. Routine and repeated screening for and treatment of mood disorders in pregnancy is recommended because of their increased rates in this population. The Edinburgh Postnatal Depression Scale administered in each trimester and postpartum, and more frequently if deemed necessary, is one option for such screening. (II-2A) 10. Pregnant adolescents should have a nutritional assessment, vitamins and food supplementation if needed, and access to a strategy to reduce anemia and low birth weight and to optimize weight gain in pregnancy. (II-2A) 11. Conflicting evidence supports and refutes differences in gestational hypertension in the adolescent population; therefore, the care usual for adult populations is supported for pregnant adolescents at this time. (II-2A) 12. Practitioners should consult gestational diabetes mellitus (GDM) guidelines. In theory, testing all patients is appropriate, although rates of GDM are generally lower in adolescent populations. Practitioners should be aware, however, that certain ethnic groups including Aboriginal populations are at high risk of GDM. (II-2A) 13. An ultrasound anatomical assessment at 16 to 20 weeks is recommended because of increased rates of congenital anomalies in this population. (II-2A) 14. As in other populations at risk of intrauterine growth restriction (IUGR) and low birth weight, an ultrasound to assess fetal well-being and estimated fetal weight at 32 to 34 weeks gestational age is suggested to screen for IUGR. (III-A) 15. Visits in the second or third trimester should be more frequent to address the increased risk of preterm labour and preterm birth and to assess fetal well-being. All caregivers should be aware of the signs and symptoms of preterm labour and should educate their patients to recognize them. (III-A) 16. It should be recognized that adolescents have improved vaginal delivery rates and a concomitantly lower Caesarean section rate than their adult counterparts. (II-2A) As with antenatal care, peripartum care in hospital should be multidisciplinary, involving social care, support for breastfeeding and lactation, and the involvement of children's aid services when warranted. (III-B) 17. Postpartum care should include a focus on contraceptive methods, especially long-acting reversible contraception methods, as a means to decrease the high rates of repeat pregnancy in this population; discussion of contraception should begin before delivery. (III-A) 18. Breastfeeding should be recommended and sufficient support given to this population at high risk for discontinuation. (II-2A) 19. Postpartum care programs should be available to support adolescent parents and their children, to improve the mothers' knowledge of parenting, to increase breastfeeding rates, to screen for and manage postpartum depression, to increase birth intervals, and to decrease repeated unintended pregnancy rates. (III-B) 20. Adolescent women in rural, remote, northern, and Aboriginal communities should be supported to give birth as close to home as possible. (II-2A) 21. Adolescent pregnant women who need to be evacuated from a remote community should be able to have a family member or other person accompany them to provide support and encouragement. (II-2A) 22. Culturally safe prenatal care including emotional, educational, and clinical support to assist adolescent parents in leading healthier lives should be available, especially in northern and Aboriginal communities. (II-3A) 23. Cultural beliefs around miscarriage and pregnancy issues, and special considerations in the handling of fetal remains, placental tissue, and the umbilical cord, must be respected. (III).

Maternal adjustment and maternal attitudes in adolescent and adult pregnant women

STUDY OBJECTIVE

This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy.

DESIGN, SETTING, AND PARTICIPANTS

A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24(th) and 36(th) weeks of gestation.

MAIN OUTCOME MEASURES

Maternal Adjustment and Maternal Attitudes Questionnaire(1) RESULTS: Adolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education.

CONCLUSION

Adolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances.

Association between abuse history and adolescent pregnancy: a meta-analysis

PURPOSE

Although a purported risk factor for early pregnancy is abuse history, the strength of this association has been inconsistent across studies and may vary as a function of abuse type. The purpose of this meta-analysis was to examine the extent to which sexual, physical, and emotional abuse, as well as neglect, increased the risk of adolescent pregnancy.

METHODS

A search of studies through MEDLINE, EMBASE, PsycINFO, Social Work Abstracts, and Web of Science was conducted. Studies were retained if they included (1) women who became pregnant before 20 years of age; (2) a comparison group of nonpregnant adolescents; and (3) abuse experience (<18 years of age).

RESULTS

Thirty-eight independent samples provided 70 estimates of effect sizes, derived from 75,390 participants. Both sexual and physical abuse were associated with an increased risk of adolescent pregnancy (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.75-2.38 and OR, 1.48; CI, 1.24-1.76, respectively). The strongest effect was for the co-occurrence of sexual and physical abuse (OR, 3.83; CI, 2.96-4.97]). Nonsignificant effect sizes were found for emotional abuse (OR, 1.01; CI, .70-1.47) and neglect (OR, 1.29; CI, .77-2.17]), although these were moderated by journal impact factor, that is, greater effect sizes were reported in higher impact journals.

CONCLUSIONS

The results of this meta-analysis reveal that the strength of the association between abuse and adolescent pregnancy varies as a function of abuse subtype. Sexual and physical abuse were associated with increased risk for adolescent pregnancy, whereas emotional abuse and neglect were not.

A population-based examination of maltreatment history among adolescent mothers in California

PURPOSE

To document the abuse and neglect histories of adolescent mothers using official child protection records.

METHODS

Vital birth records were used to identify adolescents 12-19 years of age who were born in California and gave birth in 2009. These records were linked to statewide child protective service data to determine maternal history of alleged and substantiated maltreatment victimization, as well as placement in foster care.

RESULTS

A total of 35,098 adolescents gave birth in 2009. Before conception, 44.9% had been reported for maltreatment, 20.8% had been substantiated as victims, and 9.7% had spent time in foster care.

CONCLUSIONS

These population-based data indicate that many adolescent mothers have had contact with child protective services as alleged or substantiated victims of abuse or neglect. Understanding the impact of childhood and adolescent maternal maltreatment on both early childbearing risk and subsequent parenting capacity is critical to the development of responsive service interventions.

Sexual abuse in childhood and adolescence and the risk of early pregnancy among women ages 18-22

PURPOSE

This clinic- and community-based study of young women investigated the relationship between previous sexual abuse and early pregnancy, examining the effect of the developmental period in which sexual abuse occurred and type of sexual abuse, while also providing methodological advances in the assessment of distinctive sexual abuse and its sequelae.

METHODS

Secondary data analysis using Cox proportional hazards models was conducted to determine the association between sexual abuse in childhood, in adolescence, or both, and risk of early pregnancy among 1,790 young women. In addition, this study examined the type of sexual abuse that occurred during each period.

RESULTS

As compared with women with no history of sexual abuse, women who experienced sexual abuse only in childhood had a 20% greater hazard of pregnancy; women who experienced sexual abuse only in adolescence had a 30% greater hazard of pregnancy; and women who experienced sexual abuse in both childhood and adolescence had an 80% greater hazard of pregnancy. Across these periods, attempted rape and rape were associated with an increased hazard of pregnancy. The association between sexual abuse and pregnancy was mediated by age at first intercourse and moderated by a woman's education level.

CONCLUSION

This study provides evidence that both the developmental timing and the type of sexual abuse contributes to an increased risk for early pregnancy. The study findings indicate that sexual abuse leads to an earlier age of first sexual intercourse, which in turn increases the likelihood of an early pregnancy. Women with higher educational attainment are less likely to experience early pregnancy as a result of abuse.

Making a link between childhood physical abuse and cancer: results from a regional representative survey

BACKGROUND

Abuse in childhood is associated with many negative adult health outcomes. Only 1 study to date has found an association between childhood abuse and cancer. By using a regionally representative community sample, this preliminary study sought to investigate the association between childhood physical abuse and cancer while controlling for 3 clusters of risk factors: childhood stressors, adult health behaviors, and adult socioeconomic status.

METHODS

Regional data from the Canadian provinces of Manitoba and Saskatchewan were selected from the 2005 Canadian Community Health Survey. Of the 13,092 respondents, 7.4% (n = 1025) reported that they had been physically abused as a child by someone close to them, and 5.7% (95% confidence interval [CI], 4.9-6.6) reported that they had been diagnosed with cancer by a health professional. The regional level response rate was 84%.

RESULTS

Childhood physical abuse was associated with 49% higher odds (95% CI, 1.10-2.01) of cancer when adjusting for age, sex, and race only. The odds ratio decreased only slightly to 47% higher odds (95% CI, 1.05-1.99) when the model was adjusted for all 3 clusters of risk factors.

CONCLUSIONS

A significant and highly stable association between childhood physical abuse and cancer was found even when adjusting for 3 clusters of risk factors. Further research focusing on the potential mechanisms linking childhood abuse and cancer is needed.

Childhood sexual abuse and adolescent pregnancy: a meta-analytic update

OBJECTIVE

Recent increases in adolescent pregnancies have sparked a renewed impetus to identify risk factors, such as childhood sexual abuse (CSA), associated with adolescent pregnancy. Given mixed evidence regarding the strength of the relationship between CSA and adolescent pregnancy (Blinn-Pike, Berger, Dixon, Kuschel, & Kaplan, 2002), our objective was to provide an estimate of the effect size of this relationship using updated literature and meta-analytic techniques.

METHODS

Meta-analyses of 21 studies were conducted using a random effects model of binary outcomes to determine aggregate effect-size estimates controlling for study heterogeneity.

RESULTS

CSA significantly increased the odds of experiencing an adolescent pregnancy by 2.21-fold (95% CI: 1.94-2.51). A supplemental analysis suggested that 4.5 out of 10 pregnant adolescents may have a prior history of CSA.

CONCLUSIONS

CSA places females at increased risk for subsequent adolescent pregnancy. Addressing conditions associated with CSA might impact the overall adolescent pregnancy rate.

Psychosocial conditions and suicidal behavior in pregnant teenagers : a case-control study in Brazil

OBJECTIVE

To compare the psychosocial profile and suicidal behavior of 110 pregnant teenagers (PT) with 110 non-pregnant teenagers (NPT).

METHOD

Subjects were matched by age and residential district. The research instruments used were a structured clinical interview and a self-reporting questionnaire based on psychometric scales whose answers were subjected to univariate and multivariate logistic regression.

RESULTS

Prevalence in the PT and the NPT groups were found to be as follows: attempted suicide (20.0 vs. 6.3%); depression (26.3 vs. 13.6%); anxiety (43.6 vs. 28.0%). Univariate analysis revealed the following significant associations with pregnancy: relocation in the previous 3 years (odds ratio (OR) = 6); years of schooling < or =7 (OR = 3.4); repeating a year in school (OR = 2.4); dropping out of school (OR = 5.2); death of a parent during childhood (OR = 2.9); use of alcohol/drugs in the family (OR = 2.5); previous attempted suicide (OR = 3.6); suicide by a relative (OR = 2.1); threats of physical/sexual abuse (OR = 3.5); depression (OR = 2.2); low level of social support (OR = 4.2); traumatic events (OR = 5.1) and psychosocial difficulties (OR = 4.4); prior use of tobacco and marijuana (OR = 4.0 and 4.8 respectively); weekly intake of alcohol over the previous 12 months (OR = 4.2). Multivariate analysis identified the following associations: relocation (OR = 6.4); prior use of tobacco (OR = 2.9); dropping out of school for a period in excess of 6 months (OR = 2.3); suicide by a social acquaintance (OR = 2.5).

CONCLUSION

The PT case group exhibited a psychosocial profile whose characteristics clearly differentiate this group from the NPT control group. Preventive mental health care is needed to help PT because their behavioral pattern exposes them to high risk for suicide.

[Clinical and psychological disorders of pregnant women induced by abuse]

This study is performed on a population of pregnant women during the second trimester of their pregnancy. The aim of this study is to demonstrate that clinical symptoms noticeable by the obstétricians during their consultations. Eight hundred and fifty-three patients have been involved in this study by responding to an anonymous questionnary. Hundred and seventy-five patients(groupI) have been abuse either physically or psychologically or sexually. The study shows that there is a strong difference between the groupI and the group without abuse in their medical past history (678 patients) about the occurracy of several disorders. The most frequently observed troubles are sexuals disorders, school failures, deficients relationship with others persons, anxiety and troubles of humor. We can concluded, about those clinical manifestations, that they do exist during pregnancy and probably thoses symptoms are linked to traumatism occured during their past history. Obstetricians must look after thoses symptoms very seriously to propose a good management of the pregnancy either about their psychological problems or about the social environnement in which they live.

Childhood sexual abuse, teenage pregnancy, and partnering with adult men: exploring the relationship

Although the mechanism by which early victimization, specifically sexual abuse, increases the risk of adolescent pregnancy is unclear, a relationship between previous victimization and adolescent pregnancy has been demonstrated. While partnering with an older man may initially offer the means necessary to escape a neglectful or violent family of origin, this protection be accompanied by an imbalance of power and control. Both adolescent mothers partnered with adult men and adolescent mothers partnered with male peers reported sexual abuse perpetrated by family members, family friends, strangers, and peers. Policies developed to protect young people from victimization, including mandatory reporting and statutory rape laws, should be evaluated for their consistent application to all children, regardless of age, race, gender, or pregnancy status.

The parenting project for teen mothers: the impact of a nurturing curriculum on adolescent parenting skills and life hassles

OBJECTIVE

Many teen parents and their babies are at a significant disadvantage because of poverty and inadequate parenting skills. We undertook a study aimed at increasing parenting skills and improving attitudes of teen mothers through a structured psychoeducational group model based on the Nurturing Curriculum.

METHODS

All adolescent mothers in the Young Parents' Program were offered enrollment in a 12-week group parenting curriculum (intervention group) and were compared with those who declined the intervention but agreed to participate as comparison subjects (comparison group). This study had an intervention-comparison group design with pretest and posttest measures, including the Adult-Adolescent Parenting Inventory (AAPI), the Maternal Self-Report Inventory (MSRI), and the Parenting Daily Hassles Scale (Hassles Scale).

RESULTS

There were 91 young mothers in the intervention group compared with 54 in the comparison group. While controlling for mother's age, baby's age, and race, the repeated-measures analyses showed that mothers who participated in the intervention group or attended more group sessions experienced improvements in their mothering role (MSRI) (trend), perception of childbearing experience (MSRI), appropriate developmental expectations of their child (AAPI), empathy for the baby (AAPI), and a reduction in the frequency of hassles in child and family events (Hassles Scale).

CONCLUSION

The intervention group showed improvement in parenting skills and life hassles after participation in the intervention curriculum. More interventions are needed to confirm the positive effect of the group-based interventions on parenting and life skills of young mothers that may improve the social, emotional, and cognitive outcomes for the children born to teen parents.

Nursing care for pregnant adolescents

Although the physical care of pregnant adolescents is similar to that required by adult women, adolescents have additional unique needs. Adolescents often need more support and extensive teaching during pregnancy and the postpartum. Moreover, adolescents often have fewer life experiences than do adult women, making them less able to cope with the life changes they are experiencing related to pregnancy and birth. Nonjudgmental and developmentally appropriate interactions are essential to the care of pregnant adolescents. This article explores nursing care for the physical, emotional, and educational needs of adolescents during the prenatal, intrapartum, and postpartum periods.

Links between past abuse, suicide ideation, and sexual orientation among San Diego college students

The authors explored relationships among childhood abuse, suicidal ideation, and sexual orientation of 18- to 30-year-old students enrolled in 2 San Diego area colleges, using responses from anonymous questionnaires. Sixty percent of the 138 eligible respondents were women, and 22% were self-identified gay/bisexual individuals. Women were more likely than men to report at least 1 form of emotional abuse (odds ratio [OR] = 2.3; p =.02) and unwanted sexual touching (OR = 4.3; p = .0004). Lesbian/bisexual women were significantly more likely to report past suicidal ideation than were heterosexual women (OR = 3.7, p = .03). Gay/bisexual men were more likely to report unwanted sexual touching than were heterosexual men (OR = 5.1, p = .04), but the men did not report significantly higher rates of past suicide ideation or suicide attempts. Sexual orientation and a past history of child sexual, physical, and emotional abuse could be compounding risk factors for suicidal ideation among college students.