Adolescent pregnancy (AP) is a significant public health issue. Child maltreatment (CM) represents an established risk factor, yet little is known about the explanatory mechanisms linking the phenomena. Informed by developmental theory, this study prospectively tested seven multi-level, indirect pathways that could plausibly explain the relationship between CM and AP: (1) substance use (polysubstance use and frequency); (2) sexual risk behavior; (3) depressive symptoms; (4) posttraumatic stress disorder symptoms; (5) cognitive dysregulation; (6) pregnancy desire and difficulty expectancies; and (7) age at menarche. Data came from a prospective, longitudinal cohort study of 469 ethnically diverse, nulliparous adolescent females, designed to examine the impact of substantiated CM on reproductive outcomes such as pregnancy and childbirth (265 maltreated and 204 demographically matched comparison adolescents). A multiple-mediator structural equation model was conducted to simultaneously test multiple indirect effects while accounting for confounding variables. Maltreatment had an indirect effect on pregnancy via substance use and higher pregnancy desire/lower perceived difficulty. Findings represent a step towards elucidating pathways linking CM with AP. Recommendations are offered to prevent pregnancy by addressing the pregnancy-specific mechanisms that are part of the maltreatment sequelae.

青少年怀孕（AP）是一个重要的公共卫生问题。虐待儿童（CM）是一个既定的风险因素，但人们对这些现象之间的解释机制知之甚少。根据发展理论，本研究前瞻性地测试了七种多层次、间接的途径，这些途径可以合理地解释 CM 和 AP 之间的关系：（1）物质使用（多种物质的使用和频率）；（二）性危险行为；(3)抑郁症状；(4)创伤后应激障碍症状；(5)认知失调；(6) 怀孕意愿和困难预期；(7)初潮年龄。数据来自一项对 469 名不同种族、未生育的青少年女性进行的前瞻性纵向队列研究，旨在研究证实的 CM 对怀孕和分娩等生殖结果的影响（265 名受虐待的青少年和 204 名人口统计匹配的比较青少年）。采用多中介结构方程模型来同时测试多个间接效应，同时考虑混杂变量。虐待通过物质使用和较高的怀孕愿望/较低的感知难度对怀孕产生间接影响。这些发现代表着朝着阐明 CM 与 AP 之间的联系途径迈出了一步。建议通过解决虐待后遗症中的妊娠特异性机制来预防妊娠。