Rapid repeat pregnancy and experiences of interpersonal violence among low-income adolescents

Context: Rapid repeat pregnancy (RRP) among adolescents, usually defined as pregnancy onset within 12-24 months of the previous pregnancy outcome, has frequently been the target of public health interventions, due to the exac erbation of negative consequences associated with recurrent adolescent preg nancy (and more specifically with childbearing). Objective: To examine what, if any, relationship exists between RRP and the experience of interpersonal violence and abuse among low-income adolescent s at one semi-urban health center. Design: Case-control study using retrospective chart review. Participants and Setting: 100 women aged 13-21 who received prenatal care a t one independent nonprofit health center that serves adolescents and their children from June 1994 through June 1996. Main Outcome Measures: Number and timing of pregnancies, occurrence of phys ical or sexual abuse; other psychosocial risk factors were evaluated. Results: In this population, the experience of any form of physical or sexu al violence during the study interval was associated with RRP within 12 mon ths (p = 0.01, OR = 3.46) and 18 months (p = 0.013, OR = 4.29). Other previ ously reported predictors of RRP, including family stress, financial stress , and other environmental stressors did not reach statistical significance at either 12 months or 18 months in this sample. 0% additional note, young women who experienced any form of abuse during the 12-month study interval were substantially more likely to miscarry than were their nonabused peers, and spontaneous abortion was also very strongly associated with RRP (p < 0 .00001; OR = 22.6). Conclusions: The experience of interpersonal violence is correlated with ra pid repeat pregnancy among low-income adolescents. This study strongly sugg ests a need for both extensive screening for partner and family violence am ong pregnant and postpartum adolescents, and follow-up safety planning supp ort in combination with family planning interventions. (C) 1999 American Jo urnal of Preventive Medicine.