Adolescents who report prior sexual abuse are at increased risk for adolescent pregnancy. This may result from earlier, more frequent, less well-protected sexual activity or from a greater desire to conceive. To determine the relative contribution of these two possible explanations to the reported association between sexual abuse and adolescent pregnancy, this study examined the reproductive and sexual histories of 200 sexually active 13- to 18-year-old females in relation to self-reported sexual abuse. Anonymous questionnaires showed that 40 (20 percent) of the 200 subjects reported sexual abuse. Analyses showed no group differences in the median age of first voluntary intercourse, the frequency of sexual intercourse, or the consistency of birth- control use. Compared to their nonabused peers, however, teens who reported abuse were more likely to be trying to conceive (35 percent compared to 14 percent), to have boyfriends who were pressuring them to conceive, and to have fears about infertility. The findings suggest that childhood sexual abuse may increase the risk of adolescent pregnancy by fostering the desire to conceive. Further study is needed to determine why a disproportionate number of sexually abused adolescents desire pregnancy. The efficacy of adolescent pregnancy prevention programs may be improved by identifying previously abused adolescents and by designing education interventions that specifically address their desire to conceive. 4 tables and 12 references