Association Between State-Level Teen Birth Rates and Referral for Child Maltreatment

In this ecological study, we sought to determine whether an association exists between state-level teen birth rates and child maltreatment referral rates. The exposure and outcome of interest were the annual state-level teen birth rate for girls 15–19 years and the annual state child maltreatment referral rate for children under 6 years from 2002 to 2017. Generalized estimating equation (GEE) negative binomial models were used to assess the association between state-level, race-specific annual teen birth rates and child maltreatment rates. Incidence rate ratios (IRRs) were estimated for each race category. One additional birth per 100 teens was significantly associated with a 25% greater risk of maltreatment referral among American Indian or Alaska Native children, a 45% greater risk among Asian or Pacific Islander children, an 11% greater risk among Black children, and an 18% greater risk among White children. Overall, the state rate of child maltreatment increases with the number of teen births and this effect varies significantly by race.