• Bisexual people tend to have different reproductive histories than birthing people who identify as lesbian or heterosexual, including early pregnancy. We compared histories of online and in-person sexual behavior among these three groups in a racially diverse sample of young pregnant persons. Our findings confirm previous findings of earlier and riskier sexual behavior among bisexual individuals with an early pregnancy, linking them to syndemic factors such as exposure to discrimination, intimate partner violence, and illicit substance use. Sexual and reproductive health intervention and prevention programs may be more effective if they address psychosocial health disparities in this population.

Boss N, Mark E, Coulter RWS, De Genna NM. Arch Sexual Behav.

• This is an Introduction to a Special Issue of Nicotine and Tobacco Journal focused on the latest research in prenatal nicotine and tobacco use. We also identified gaps in the literature: more research is needed outside the US, UK and Australia, especially studies that include the expertise of people with lived experience and studies conducted in lower- and middle-income countries (LMIC). We need to “think outside the box” to find new solutions, ensuring that every birthing person has access to evidence-based and effective nicotine and tobacco cessation programs, including programs developed with and tailored for specific communities

De Genna NM, Stroud R, Bar-Zeev, Y. Nic Tob Res, 2026 Jul 10:ntag158.
DOI: 10.1093/ntr/ntag158

• We interviewed 38 pregnant individuals ages 17-21 years old about prenatal cannabis use, finding that they held mixed beliefs about its safety, with some believing it was helpful to treat prenatal nausea and stress. Participants highlighted a desire to make their own decisions and sought information from trusted sources.

Sanfacon AE, Chou C, Saloom S, Lehman D, Chang JC, De Genna NM. Cannabis, 2026
DOI: 10.26828/cannabis/2026/000369

• Although plurisexual (bisexual, pansexual, sapiosexual) adolescents and young adults are more likely to experience pregnancy at an early age, little is known about their perinatal health care experiences. We spoke with 16–24-year-old plurisexual birthing people to learn (predominantly Black and biracial) about their experiences, learning about disclosure preferences, fears about stigma, and how pregnancy interacts with sexual identity. Findings highlight the need for pregnancy providers to avoid assumptions of young patients’ heteronormativity and proactively engage in inclusive conversations about sexuality and reproductive healthcare with all patients.

Mark E, Hossain F, Boss N, Frankenberger, J, Coulter RWS, De Genna NM. J Bisexuality, 2026;26:165-185.
DOI: 10.1080/15299716.2025.2604487

• This review of the literature on theory-based tobacco control for sexual and gender minority (SGM) people won the journal’s Editor’s Choice award. This review found a relative lack of theoretical models applied in tobacco control initiatives for SGM people. Large-scale tobacco control initiatives may cause unique harm to SGM samples when critical theories are not integrated into their design and implementation.

Lee J, Smith AD, Downey DL, Mabrouk FA, Nunez A, Sikora N, Byron MJ, Cheney MK, De Genna NM, Khayat A, Maglalang DD, Patterson JG, Rose SW, Sun CJ, Tan ASL, Weinberger AH, Hinds JT. Nic Tob Res, 2026;28:526-535. PMID: 40973055 [Editor’s Choice]
DOI: 10.1093/ntr/ntaf193

• Adolescents and young adults are more likely to experience fear of childbirth. This is the first US study of fear of childbirth in this age group. We found that contextual factors were associated with fear of childbirth including child abuse and experiences of discrimination. Shifting the focus of care from individual-level attributes associated with health disparities to social determinants of health and contextual factors allows for a health equity-focused population level approach to this vulnerable population.

De Genna NM, Kolko-Conlon RP, Spada M, Gopalan P. BMC Pregnancy Childbirth, 2025;25,735. PMID: 40634867.
doi: 10.1186/s12884-025-07841-4

• Maternal-fetal attachment refers to a pregnant person’s emotional connection to the growing fetus. The results of this study confirm the importance of social support for maternal-fetal attachment in younger pregnant individuals and highlight the unique contribution of mentorship for this population. In addition to enhancing social support and mentorship opportunities, findings suggest that interventions to reduce fear of childbirth may strengthen maternal-fetal attachment in younger patients.

Alavala, V, De Genna NM. PLoS One, 2025;20:e0319449. PMID: 40601548.
DOI: 10.1371/journal.pone.0319449

• This is the first study that examines the role of prenatal cannabis and tobacco use in relationships with intimate partner violence (IPV). We interviewed 15 survivors and 19 IPV advocates, finding themes relating to survivors’ use, interpersonal coercive tactics, and systems-level control. Specific findings included (1) survivors using substances to cope; (2) abusive partners coercing survivors through withholding, controlling, and punishing substance use; (3) shame and stigma are key drivers of coercion; (4) partners hinder cessation efforts; and (5) child protective services and health care are systems used by abusive partners to control and manipulate perinatal survivors of IPV.

Groves P, Laubacher C, Salib Y, Mickievicz E, Duplessis V, Molinaro N, Méndez DD, Guyon-Harris K, Martinez R, Chang J, De Genna NM, Ragavan MI. Women’s Health Reports, 2025;6: 153-162. PMID: 41142487
DOI: 10.1177/26884844251387024

• This study provides novel information about cannabis use in young sexual minority people before and during pregnancy. Participants described transitions in their patterns and reasons for cannabis use and facilitators for reduction of cannabis use.

Boss N, Frankeberger J, Hossain F, Mark E, Coulter RWS, De Genna NM. Substance Use & Addiction Journal. 2025;0(0).
DOI: 10.1177/29767342241310950

• Structural stigma is a potentially important source of variability in SGM tobacco use and cessation that is unaccounted for in much of the research conducted to date, with even less research focused on intersectional structural stigma.

Tamar Antin, DrPH, Francisco Cartujano-Barrera, MD, Natacha M De Genna, PhD, Josephine T Hinds, PhD, Emily Kaner, MPH, Juhan Lee, PhD, Joanne G Patterson, PhD, Raymond A Ruiz, PhD, Tamara Stimatze, PhD, Andy S L Tan, PhD, Jaimee L Heffner, PhD. Nicotine & Tobacco Research. 27 November 2024
DOI: 10.1093/ntr/ntae280

• By telling their own stories, sexual minority participants with lived experience of nicotine and tobacco use described the evolution of their motivations to use these products over time, cannabis use as a precipitant, the importance of pregnancy for smoking cessation, and perceptions about effective and ineffective factors in cessation efforts.

De Genna NM, Boss N, Hossain F, Frankeberger J, Mark E, Coulter RWS. Nicotine & Tobacco Research. 26 July 2024
DOI: 10.1093/ntr/ntae189/7721395

• One in five older adults living in a US state where recreational marijuana use is illegal had a history of marijuana use. Recent marijuana use was less common but consistent with prior research, associated with other substance use and poorer mental health.

De Genna NM, Jacobsen E, Ganguli M. International journal of geriatric psychiatry. 2024 Apr;39(4):e6086.
DOI: 10.1002/gps.6086

• In this study of pregnant adolescents and young adults, those who identified as plurisexual were more likely to report intimate partner violence (IPV) than those who identified as heterosexual. Our findings highlight the potentially important role that parental monitoring plays for pregnant adolescents and young adults, and the greater protective role parental monitoring may play for young people experiencing marginalization.

Ragavan MI, Coulter RW, Sickler L, Shaw DS, De Genna NM. LGBT health. 2024 Apr 4.
DOI: 10.1089/lgbt.2023.0288

• This report examines pathways from prenatal cocaine exposure (PCE) to behavioral outcomes in the 25-year-old offspring. There were two pathways from PCE to adult marijuana use via adolescent and young adult behaviors. These findings are consistent with those from previous phases and are an indication that there are detrimental associations with PCE that persist across developmental stages and into adulthood.

Richardson GA, De Genna NM, Willford JA, Goldschmidt L. Neurotoxicology and Teratology. 2024 Feb 17:107335.
DOI: 10.1016/j.ntt.2024.107335

• To document pregnancy and birthing experiences of young, Black pregnant women in one geographic area to make recommendations for improving young Black women’s pregnancy and birthing experiences.

Hill AV, Balascio P, Moore MC, Hossain F, Dwarakanath M, De Genna NM. SSM-Qualitative Research in Health, 2023;4:100333.
DOI: 10.1016/j.ssmqr.2023.100333

• The novel coronavirus 2019 (COVID-19) pandemic exacerbated existing health inequities in the United States, but no studies have focused on the lived experiences of younger Black birthing people. The goal of this qualitative study was to center the experiences of younger pregnant and birthing Black and Biracial people during the pandemic.

De Genna NM, Hossain F, Dwarakanath M, Balascio P, Moore MC, Hill AV. Birth Defects Res, 2023; Oct 8, 1-11. doi: 10.1002/bdr2.2262. PMID: 37807480
DOI: 10.1002/bdr2.2262

• Sexual minority (SM) youth have higher rates of substance use and pregnancy but are absent from the prenatal substance use literature. We modeled the impact of SM identity and syndemic factors on prenatal substance use among 14- to 21-year-olds.

De Genna NM, Coulter RWS, Goldschmidt L, Boss N, Hossain F, Richardson GA. LGBT Health. 2023 Jul 6. PMID: 37410511
DOI: 10.1089/lgbt.2023.0026

• One in four Americans have used cannabidiol (CBD) products in the past year, and use has become prevalent in many Western countries with recent deregulation from a controlled or illicit substance to an unrestricted product. CBD is also marketed to pregnant people to treat common medical conditions. However, preclinical work has linked cannabidiol exposure to embryotoxicity, as well as neuroendocrine, reproductive, and behavioral effects in offspring. No studies have examined the prevalence or correlates of CBD use among pregnant people. Demographic, medical, and psychosocial correlates of cannabidiol use were examined in the YoungMoms study, a cohort of pregnant people under the age of 22, a population that is at high risk for cannabis use during pregnancy.

De Genna NM, Kennon-McGill S, Goldschmidt L, Richardson GA, Chang JC. Neurotoxicol Teratol, 2023;96:107162 PMID: 36717004
DOI: 10.1016/j.ntt.2023.107162

• Many studies have examined changes in marijuana use across adolescence, but few have examined factors associated with transitions from adolescence to young adulthood. We examined prenatal exposures to alcohol and marijuana and adolescent risk and protective factors that best distinguished among abstinence, continuity, or cessation of marijuana use from 16 to 22 years.

Goldschmidt L, Richardson GA, Day NL, De Genna NM. Neurotoxicol Teratol, 2023 Jul 10;107287. PMID: 37437668
DOI: 10.1016/j.ntt.2023.107287

• The objective of this study was to qualitatively examine coping mechanisms and desired supports in pregnant and birthing Black and Biracial adolescent and young adult women during the COVID-19 pandemic.

Dwarakanath M, Hossain F, Balascio P, Moore MC, Hill AV, De Genna NM. BMC Pregnancy Childbirth, 2023 Sep 4;23(1):636. PMID: 37667206
DOI: 10.1186/s12884-023-05929-3

• This study provides evidence for 4 distinct trajectories of relapse to cigarette use in the postpartum, and highlights variables linked to early relapse that may improve efforts to target and time intervention efforts. Specifically, assessing age at initiation, quantity of tobacco use prior to quit attempt, and number of previous quit attempts will identify pregnant people at greatest risk of early postpartum relapse.

De Genna NM, Qu Y, Cheng Y, Tavernier RL, Kolko RP, Levine MD. Nic Tob Res. 2022 Nov 19;ntac263. DOI: 10.1093/ntr/ntac263. Online ahead of print.

• This review discusses methodological considerations for studies of prenatal cannabis exposure, including the assessment of exposures, covariates, and outcomes, and reviews findings from prospective, longitudinal studies.

De Genna NM, Willford JA, Richardson GA. Pharmacol Biochem Behav, 2022; 214:173358. DOI: 10.1016/j.pbb.2022.173358

• This study examines the syndemics of STIs in pregnant people less than 22 year of age using preliminary data from the YoungMoms. Rates of STI were high and demonstrated evidence of syndemics. Findings also highlight heterogeneity among younger Black pregnant participants from this sample.

Hill AV, Mendez DD, Haggerty CL, Miller E, De Genna NM. Matern Child Health J, 2022;1-10. DOI: 10.1007/s10995-021-03335-9

• Although prenatal cocaine exposure has been associated with earlier initiation of sex in prior studies, it was not directly associated with risky adult sex or history of STI in this cohort. Exposed individuals were at greater risk of sex under the influence of alcohol or drugs via earlier initiation of cannabis use.

De Genna NM, Goldschmidt L, Richardson GA, Day NL.  Neurotoxicol Teratol, 2022;89:107060. DOI: 10.1016/j.ntt.2021.107060

• This study found that a history of any cannabis use was associated with maternal smoking during and after pregnancy in the LEAP study. Women with Cannabis Use Disorder were not more likely to smoke cigarettes in the perinatal period than women with any history of cannabis use.

De Genna NM, Germeroth L, Benno MT, Wang B, Levine MD. Mat Child Health, Mat Child Health, 2021; 1-8. DOI: 10.1007/s10995-021-03246-9

• This study traces a pathway from prenatal marijuana exposure to adult memory function in a MHPCD cohort, highlighting the role of early marijuana use. Initiating marijuana use before age 15 placed young adults at greater risk of memory deficits, even after controlling for childhood memory and current marijuana use. Prenatal marijuana exposure also indirectly predicted young adult memory function via childhood memory deficits and early initiation of marijuana.

Willford JA, Goldschmidt L, De Genna NM, Day NL, Richardson GA. Neurotoxicol Teratol, 2021; 84:106958. DOI: 10.1016/j.ntt.2021.106958

• This qualitative study highlights key facilitators and barriers to campus service use for students with disabilities with sexual violence histories and suggest key intervention points for increasing accessibility, reducing stigma, and improving student experiences with campus providers, staff, and faculty.

Richter RK, Anderson JC, Miller E, Bonomi AE, DeGenna NM, Feinstein Z, Kass G, Lampe K, Mathier A, Chugani CD. Qual Health Res, 2021; 1-12. DOI: 10.1177/1049732321998054

• This study using MHPCD data identified pathways from prenatal cannabis and tobacco exposure to adult daily dual use, in addition to clarifying adolescent outcomes that may be part of the pathways.

De Genna NM, Goldschmidt L, Richardson GA, Cornelius MD, Day N. Addict Behav, 2021; 116: 106820.  DOI: 10.1016/j.addbeh.2021.106820

• This qualitative study examines college students’ perceptions of campus programming to prevent alcohol and sexual violence. Students with disabilities described current programming as ineffective and irrelevant to their experiences. Students need multi-dose, developmentally relevant content that directly addresses the complexities of their experiences with disability, alcohol, and violence.

Chugani C, Anderson JC, Richter, RK, Bonomi AE, DeGenna NM, Feinstein Z, Jones KA, Miller E. J Fam Viol 36, 281–291 (2021). DOI: 10.1007/s10896-020-00150-8

• This study provides evidence that nonpunitive responses to bad grades and cognitive stimulation at home are linked to academic achievement among high-risk Black adolescents from a MHPCD cohort.

Hardaway CR, Sterrett-Hong EM, De Genna NM, Cornelius MD. J Youth Adolesc, 2020; 45:1043-1056. DOI: 10.1007/s10964-020-01217-x