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Background <p>Sexual violence against children is a severe violation of human rights and a persistent public health problem, with early pregnancy representing one of its most serious consequences. Although national studies in Brazil have identified geographic disparities in pregnancies resulting from statutory rape, intrastate heterogeneity remains insufficiently explored. This study aimed to describe the epidemiological profile of pregnancies among girls aged 14 years or younger interpreted under the Brazilian legal framework of statutory rape in the state of Bahia and to analyze their spatiotemporal distribution between 2014 and 2023.</p> Methods <p>A spatiotemporal ecological study was conducted using secondary, aggregated data from the Live Birth Information System (SINASC) and the Mortality Information System (SIM), including live births and fetal deaths (≥ 22 weeks of gestation) among mothers aged ≤ 14 years residing in Bahia. Annual pregnancy rates per 1,000 female inhabitants aged 10–14 years were calculated by health region. Sociodemographic and clinical characteristics were described using absolute and relative frequencies. Spatiotemporal clusters with elevated risk were identified using Kulldorff’s scan statistic with a discrete Poisson model, retrospective analysis, 999 Monte Carlo replications, and a 5% significance level.</p> Results <p>Between 2014 and 2023, 19,235 pregnancies were identified, including 18,914 live births and 321 fetal deaths. Most mothers self-identified as Brown, had low educational attainment, and were single. Preterm birth occurred in 17.5% and low birth weight in 14.0% of live-born infants. The statewide pregnancy rate declined from 3.5 to 2.5 per 1,000 girls aged 10 to 14 years (− 28.6%); however, marked regional disparities persisted. Four statistically significant spatiotemporal clusters were detected (<i>p</i> &lt; 0.05), with relative risks ranging from 1.36 to 1.59, primarily concentrated in the South, Far South, North, and North-Central regions. Recurrent clusters across different periods indicated persistent territorial vulnerability.</p> Conclusions <p>Despite an overall decline in rates, pregnancies among girls aged ≤ 14 years in Bahia, interpreted under the Brazilian legal framework of statutory rape, remain territorially concentrated, with persistent high-risk clusters. The persistence of high-risk clusters underscores the need for targeted, territorially tailored interventions integrating health care, surveillance, education, social assistance, and justice systems to prevent sexual violence and mitigate its reproductive consequences.</p>

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Spatiotemporal distribution of pregnancies among girls aged 14 years or younger in Bahia, Brazil, 2014–2023: an ecological study under the Brazilian legal framework of statutory rape

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  • 发表日期：

    2026年7月3日

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  • Rogério Ribeiro Ramos,
  • Rita Carvalho-Sauer,
  • Enny S. Paixao,
  • Theolis Costa Barbosa Bessa

摘要

Background

Sexual violence against children is a severe violation of human rights and a persistent public health problem, with early pregnancy representing one of its most serious consequences. Although national studies in Brazil have identified geographic disparities in pregnancies resulting from statutory rape, intrastate heterogeneity remains insufficiently explored. This study aimed to describe the epidemiological profile of pregnancies among girls aged 14 years or younger interpreted under the Brazilian legal framework of statutory rape in the state of Bahia and to analyze their spatiotemporal distribution between 2014 and 2023.

Methods

A spatiotemporal ecological study was conducted using secondary, aggregated data from the Live Birth Information System (SINASC) and the Mortality Information System (SIM), including live births and fetal deaths (≥ 22 weeks of gestation) among mothers aged ≤ 14 years residing in Bahia. Annual pregnancy rates per 1,000 female inhabitants aged 10–14 years were calculated by health region. Sociodemographic and clinical characteristics were described using absolute and relative frequencies. Spatiotemporal clusters with elevated risk were identified using Kulldorff’s scan statistic with a discrete Poisson model, retrospective analysis, 999 Monte Carlo replications, and a 5% significance level.

Results

Between 2014 and 2023, 19,235 pregnancies were identified, including 18,914 live births and 321 fetal deaths. Most mothers self-identified as Brown, had low educational attainment, and were single. Preterm birth occurred in 17.5% and low birth weight in 14.0% of live-born infants. The statewide pregnancy rate declined from 3.5 to 2.5 per 1,000 girls aged 10 to 14 years (− 28.6%); however, marked regional disparities persisted. Four statistically significant spatiotemporal clusters were detected (p < 0.05), with relative risks ranging from 1.36 to 1.59, primarily concentrated in the South, Far South, North, and North-Central regions. Recurrent clusters across different periods indicated persistent territorial vulnerability.

Conclusions

Despite an overall decline in rates, pregnancies among girls aged ≤ 14 years in Bahia, interpreted under the Brazilian legal framework of statutory rape, remain territorially concentrated, with persistent high-risk clusters. The persistence of high-risk clusters underscores the need for targeted, territorially tailored interventions integrating health care, surveillance, education, social assistance, and justice systems to prevent sexual violence and mitigate its reproductive consequences.