Interpersonal Trauma in Low-Income Adolescent Mothers: The Epidemiology of an Unrecognized Epidemic

Background and Purpose: Pregnancy and motherhood during adolescence have been linked to distal and proximal negative outcomes for mother and offspring including low infant birth weight, impaired maternal bonding, and adverse infant biological and neurodevelopmental deficits.  Considerable research supports relationships between childhood interpersonal trauma, childbearing, and perinatal depression (PND) in adolescent women. However, estimates of the prevalence of childhood interpersonal trauma in this population have not been well studied. While screening for PND and intimate partner violence (IPV) in perinatal clinics serving adolescent mothers has improved over the past decade, childhood interpersonal trauma is rarely discussed or documented. This study seeks to estimate the prevalence of childhood interpersonal trauma in adolescent mothers and will discuss implications for practice, policy, and future research.

Methods: We recruited a sample of 224 adolescents aged 14-20 during routine prenatal visits at a public health prenatal care clinic. Measures of depression, childhood trauma history, and intimate partner violence (IPV) were administered prenatally and postpartum. Analyses examined the prevalence childhood trauma including childhood maltreatment, IPV, and caregiver loss. In order to examine the implications of experiencing more than one type of childhood interpersonal trauma, we created an additive scale of traumatic experiences to estimate the prevalence polytraumatization. The prevalence of PND is also examined.

Results:  Our sample included a diverse group of adolescent mothers (55.3% Latina, 28.7% Black,16% White). Nearly 82% of subjects reported experiencing one dimension of childhood interpersonal trauma. IPV was reported by 75% of our sample, 12.4% reported sexual IPV, 49.3% reported physical IPV, and 72.7% reported psychological IPV. Nearly 30% of the subjects reported losing a primary caregiver and 28.4% report a history of child maltreatment. Emotional neglect was the most common form of child maltreatment (16.9%), followed by sexual abuse (10.7%), and physical abuse (8.42%). Over 64% of the sample reported experiencing multiple domains of childhood interpersonal trauma with 40% reporting three or more domains and 23.8% reporting four or more.

Conclusions and Implications: Results indicate that there is an unrecognized and untreated epidemic of childhood interpersonal trauma in adolescent mothers that has lasting negative impacts on the young mothers and their offspring. The majority of young mothers experience more than one domain of childhood interpersonal trauma. Experiencing more than one domain of trauma is associated with an increased risk of negative proximal and distal outcomes. Childhood interpersonal trauma is more widespread than perinatal depression in low-income adolescent mothers, yet screening and treatment efforts targeting trauma have been extremely limited. Future research, policy and practice should focus on screening for childhood in perinatal clinics and on developing and implementing trauma informed interventions to improve outcomes for young adolescent mothers and their offspring. Given the epidemic levels of childhood interpersonal trauma reported in adolescent mothers, universal intervention may be warranted. The high prevalence of trauma exposure in this population suggests that, at the very least, any intervention for adolescent mothers include a trauma component to enhance outcomes for mothers and their offspring.