Childhood adversity and adolescent motherhood: A cross-sectional study of trauma, partner age gaps, and parenting in the Dominican Republic

BACKGROUND: Adolescent pregnancy is increasingly understood as closely associated with pre-existing disadvantage, yet critical gaps remain regarding which adverse childhood experiences (ACEs) are associated with early childbearing, partner characteristics, and parenting trajectories. OBJECTIVE: To examine associations among ACEs, partner characteristics, and parenting practices in adolescent versus adult-onset mothers. PARTICIPANTS AND SETTING: We recruited 1019 mothers of children aged 24-48 months from poverty-focused programs in Santo Domingo, Dominican Republic (November 2024-January 2025), classified as current adolescent mothers (n = 91), former adolescent mothers (n = 316), or adult-onset mothers (n = 598). METHODS: Data collected via Audio Computer-Assisted Self-Interview using validated instruments: ACE questionnaire, HITS violence screen, Edinburgh Postnatal Depression Scale, and standardized parenting assessments. Analyses included correlations, chi-square tests, t-tests, ANOVA, and regression models. RESULTS: = 0.089); partners also had lower educational attainment (40.4% primary-only vs 13.0%). ACE scores were independently associated with intimate partner violence and depression after covariate adjustment; maternal age was not. Adult-onset mothers maintained 2.85 times the odds of university education after age adjustment. Former adolescent mothers used less violent discipline than adult-onset mothers (d = -0.22, p < .001), robust to adjustment. CONCLUSIONS: The findings support the view that preexisting adversity rather than early childbearing is associated with higher psychosocial risk. Educational inequalities persisted after age adjustment. Former adolescent mothers' lower use of violent discipline is consistent with possible adaptation, though alternative explanations cannot be excluded. RESEARCH IN CONTEXT: Evidence before this study. We searched PubMed, EBSCOhost, EMBASE, and SciSpace online databases for "adolescent pregnancy" and "early childhood development." We included publications in any language between 2015 and 2024 and screened 283 studies, plus 23 earlier studies cited in these publications; we excluded all other publications. Most examined cumulative ACE scores rather than specific adversities. Only 11 studies included the child's biological father data, focusing solely on age differences without educational characteristics. No studies examined whether parenting deficits persist as adolescent mothers mature or linked childhood emotional neglect to partner characteristics. The selection effects hypothesis suggests that preexisting disadvantage may explain poor outcomes, but evidence remained limited regarding specific mechanisms and long-term trajectories. Added value of this study. We identify specific ACEs-emotional neglect and physical neglect-that show stronger associations with early childbearing than cumulative ACE scores. We document that adolescent mothers' partners average 9.1 years older at the time of the first childbirth and have lower education (40.4% primary-only versus 13.0% for older mothers' partners). In exploratory analyses, different childhood adversities show opposing associations with partner characteristics: feeling unloved was associated with younger partners, while sexual abuse and witnessing maternal intimate partner violence were associated with older partners, independent of reproductive timing-associations that did not survive correction for multiple comparisons and require replication. Comparing former adolescent mothers with adult-onset mothers, we find that former adolescent mothers use less violent discipline despite persistent adversity-a pattern consistent with a possible adaptation that was robust to covariate adjustment-while educational inequalities persist after age adjustment, with adult-onset mothers having 2.85 times the odds of university education compared to former adolescent mothers. Implications of all the available evidence. Adolescent pregnancy may be better understood as closely associated with pre-existing disadvantage rather than as an independent source of disadvantage. Prevention efforts may benefit from addressing childhood trauma, particularly emotional and physical neglect, rather than focusing solely on pregnancy prevention. Programs should consider how to address power dynamics in age-asymmetric relationships while expanding opportunities for young women. The lower use of violent discipline among former adolescent mothers, if replicated, would challenge deficit perspectives and support strengths-based approaches. Healthcare systems may consider screening for childhood adversity and relationship dynamics during prenatal care as one strategy to identify women who could benefit from trauma-informed services. Future longitudinal research should examine adaptation trajectories and protective factors that enable positive outcomes despite adversity.