E-Cigarette Use During Pregnancy and its Association with Adverse Birth Outcomes

Abstract

The popularity of e-cigarette use among young adults is a growing concern. However, little is known about factors associated to e-cigarette use in pregnant women and birth outcomes. In this retrospective cohort study, we evaluated the influence of several factors on behavioral changes in e-cigarette use before and during pregnancy, and assessed the association between e-cigarette use and subsequent birth outcomes among pregnant women. The Population Assessment of Tobacco and Health (PATH) study waves 1 to 4 (2013-2018) were used. Multivariate logistic regressions were conducted to estimate behavioral changes in e-cigarette use during pregnancy and subsequent influence on high-risk birth (e.g., preterm birth, low birth weight, birth defects, etc) and fetal death. We found pregnant women who quitted vaping before pregnancy showed no differential risk of having a high-risk birth (OR=1.36, 95% CI 0.50 – 3.70) compared to did not vape. On the other hand, those who have ever vaped during pregnancy had a greater likelihood of experiencing a high-risk birth (OR=3.05, 95%CI 1.11 – 8.33, p < 0.05) compared to women who did not initiate vaping. In conclusion, pregnant women who have ever vaped during pregnancy showed elevated risk of having high-risk birth than those who did not vape. But those who opted to quit vaping before pregnancy showed no differences in the risk of having high risk birth compared to non-users. Healthcare providers should encourage e-cigarette users to quit prior and during early pregnancy.

Note:

Funding Information: Xiaozhong Wen's time effort on this project was covered through R21 exploratory research support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH) grants R21 DA053638 and R21HD091515 and its Diversity Supplement 3R21HD091515-02S1.

Declaration of Interests: The authors report no conflict of interest.

Ethical Approval Statement: The Population Assessment of Tobacco and Health (PATH) Study Public-Use Files are publicly available and deidentified; per the US Department of Health and Human Services guidelines, this study was exempted from institutional review broad approval.

Keywords: e-cigarettes, Pregnant, High-risk birth, Smoking cessation