Vaping During Pregnancy Increases Risk of Maternal and Newborn Problems by Over 50%

A major new systematic review and meta-analysis has found that using e-cigarettes during pregnancy is associated with an approximate 50% increase in the odds of adverse outcomes for both the mother and the newborn. This comprehensive study, which pooled the results of 25 studies published as of July 2024, adds to a growing body of evidence highlighting the potential harms of vaping during this critical period. The findings challenge the narrative that e-cigarettes are a harmless alternative for pregnant individuals.

Key Findings: Increased Risks for Mother and Baby

The meta-analysis, published in the Journal of Hazardous Materials, analyzed data from 23 studies involving a total of 924,376 participants, with 7,552 of them reporting the use of only e-cigarettes during pregnancy. To ensure the results were not skewed by the risks of combustible tobacco, the researchers specifically excluded “dual users” who also smoked traditional cigarettes.

The analysis revealed two key conclusions:

1. Increased Risk of Adverse Maternal Outcomes: Prenatal vaping was associated with 53% higher odds of a negative maternal outcome. This was particularly evident in decreased rates of breastfeeding and a reduced prevalence of receiving adequate prenatal care among those who vaped.
2. Increased Risk of Adverse Neonatal Outcomes: Similarly, prenatal vaping was linked to 53% higher odds of a negative outcome for the newborn. Specific risks included:
   • Low Birth Weight: 56% higher odds
   • Preterm Birth: 49% higher odds
   • Small for Gestational Age: 48% higher odds

These findings from human studies are consistent with previous animal data, which has shown that exposing pregnant mice to e-cigarette aerosol can inhibit lung and skeletal development in their fetuses, much like exposure to cigarette smoke does.

Implications for Public Health and Policy

The authors of the meta-analysis state that their work is the “first comprehensive systematic review and meta-analysis demonstrating vaping during pregnancy as a risk factor for increased odds of both maternal and neonatal outcomes.” They underscore the urgency for increased awareness and regulation of vaping products due to their potential harms.

This evidence creates a complex situation for public health policy. For instance, in England, public health initiatives have encouraged pregnant women who smoke to switch to e-cigarettes as a harm reduction strategy to help them quit combustible tobacco. However, this new comprehensive analysis strongly suggests that e-cigarettes themselves are not without significant risks to pregnancy. The authors of the source article conclude that based on this evidence, e-cigarettes should not be promoted to pregnant people.

The full study, “Associations between vaping during pregnancy and perinatal outcomes: A systematic review and meta-analysis,” can be found in the Journal of Hazardous Materials and is available on PubMed under PMID: 39754882.