National Clearinghouse on Homeless Youth and Families

The Association Between Adverse Childhood Experiences and Adolescent Pregnancy, Long-Term Psychosocial Consequences, and Fetal Death

Hillis, S. D.,
Anda, R. F.,
Dube, S. R.,
Felitti, V. J.,
Marchbanks, P. A.,
Marks, J. S.
Journal Article
Year Published: 2004
American Academy of Pediatrics
Pediatrics 113(2):320-327 February 2004
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

These authors examined whether adolescent pregnancy increases as types of adverse childhood experiences (ACE score) increase, and whether ACEs or adolescent pregnancy are the principal source of elevated risk for long-term psychosocial consequences and fetal death. The sample consisted of 9,159 women over age 18 (mean 56 years) who attended a primary care clinic in 1995-1997. Sixty-six percent of the women reported one or more ACEs. Teen pregnancy increased from 16 percent in those with no ACEs to 53 percent in those with 8 ACEs. As the ACE score rose from zero to 5 or more, odds ratios for each adult consequence (family, financial, and job problems; high stress; and uncontrollable anger) also increased. Adolescent pregnancy was not associated with any of these adult outcomes in the absence of childhood adversity. The ACE score was associated with increased risk for fetal death after first pregnancy, but teen pregnancy was not related to fetal death. Results suggest that the negative psychosocial consequences and fetal deaths commonly attributed to adolescent pregnancy result from underlying ACEs rather than adolescent pregnancy per se. Modified Author Abstract.

Correspondence to: Susan D. Hillis, PhD, MS, Mailstop K-34, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341-3724; E-mail:, Website:
Copyright Protected
Accession Number: