Abused boys, battered mothers, and male involvement in teen pregnancy
Abused boys, battered mothers, and male involvement in teen pregnancy
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DOI：
10.1542/peds.107.2.e19
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发表时间：
2001-02-01
期刊：
影响因子：
8
通讯作者：
Marks, JS
中科院分区：
文献类型：
--
作者：
Anda, RF;Felitti, VJ;Marks, JS
背景。少年时期遭受身体虐待、性虐待或遭受母亲虐待与随后使少女怀孕的风险之间的关系此前尚未被研究过。在一项回顾性队列研究中，在一家大型健康维护组织的初级保健诊所中，对4127名男性的问卷调查结果进行了分析。答复者提供了使其怀孕的最年轻女性的年龄、自己当时的年龄，以及关于儿童时期遭受身体或性虐待和母亲遭受殴打的信息。根据这三种不良的童年经历，我们计算了使少女怀孕的患病率并调整了比值比（OR），而不考虑男性怀孕时的年龄。使用逻辑回归，调整了男性在调查时的年龄、种族和教育程度的or。19%的男性报告说他们曾经让十几岁的女孩怀孕。在儿童时期，32%的受访者遭受过身体虐待，15%遭受过性虐待，11%的受访者的母亲遭受过虐待。与报告没有虐待的受访者相比，经常对母亲进行身体虐待或殴打使少女怀孕的风险分别增加了70% （or: 1.7； 95%可信区间[CI]: 1.2-2.5）和140% （or: 2.4； 95%可信区间[CI]: 1.1-5.0）。男孩在10岁或更小时遭受性虐待，使少女怀孕的风险增加80% (or: 1.8; 95% CI: 1.3-2.4)；性侵犯伴暴力使风险增加110% （OR: 2.1; 95% CI: 1.2-3.4）。我们发现暴露类型的数量与少女怀孕的风险之间存在剂量-反应关系；报告所有三种暴露的男性比没有暴露的男性有两倍以上的可能性（OR: 2.2; 95% CI: 1.4-3.5）。少年时期遭受身体虐待或性虐待或遭受母亲的虐待与青少年怀孕的风险增加有关——在青春期和成年期都是如此。由于这些暴露是常见且相互关联的，有这些经历的男孩和成年男子应通过儿科医生和其他卫生保健提供者的常规筛查加以识别，并就性行为和避孕提供咨询。这样的努力可以防止少女怀孕，防止虐待儿童和家庭暴力的代际传播。
Background. The relationship between boyhood exposure to physical abuse, sexual abuse, or to a battered mother and subsequent risk of impregnating a teenage girl has not previously been examined.Methods. In a retrospective cohort study set in a primary care clinic for adult members of a large health maintenance organization, questionnaire responses from 4127 men were analyzed. Respondents provided the age of the youngest female whom they had impregnated, their own ages at the time, and information regarding childhood exposure to physical or sexual abuse and battered mothers. We calculated the prevalence and adjusted odds ratio (OR) for having impregnated a teenage girl according to these 3 adverse childhood experiences, regardless of the male's age at the time of impregnation. Using logistic regression, ORs were adjusted for the male's age at time of survey, race, and education.Results. Nineteen percent of the men reported that they had ever impregnated a teenage girl. During childhood, 32% of respondents had been physically abused, 15% sexually abused, and 11% had battered mothers. Compared with respondents reporting no abuse, frequent physical abuse or battering of mothers increased the risk of involvement in teen pregnancy by 70% (OR: 1.7; 95% confidence interval [CI]: 1.2-2.5) and 140% (OR: 2.4; 95% CI: 1.1-5.0), respectively. Sexual abuse as a boy at age 10 years or younger increased the risk of impregnating a teenage girl by 80% (OR: 1.8; 95% CI: 1.3-2.4); sexual abuse with violence increased the risk by 110% (OR: 2.1; 95% CI: 1.2-3.4). We found a dose-response relationship between the number of types of exposures and the risk of impregnating a teenage girl; men who reported all 3 types of exposures were more than twice as likely to have been involved than those with no exposures (OR: 2.2; 95% CI: 1.4-3.5).Conclusions. Boyhood exposure to physical or sexual abuse or to a battered mother is associated with an increased risk of involvement in a teen pregnancy-during both adolescence and adulthood. Because these exposures are common and interrelated, boys and adult men who have had these experiences should be identified via routine screening by pediatricians and other health care providers and counseled about sexual practices and contraception. Such efforts may prevent teen pregnancy and the intergenerational transmission of child abuse and domestic violence.