BACKGROUND AND PURPOSE:

• Regan et al. (Obstetrics & Gynecology, 2021) evaluated the risk of adverse birth outcomes among adults who use e-cigarettes before and during pregnancy

METHODS:

• Retrospective cohort study
• Population
  • Individuals with a recent live birth
  • Data from the 2016-2018 PRAMS (Pregnancy Risk Assessment Monitoring System)
• Exposure
  • E-cigarette use during the 3 months before pregnancy
  • E-cigarette use during the last 3 months of pregnancy
• Study design
  • Multivariable logistic regression models used to develop adjusted prevalence ratios
  • Stratification: Prenatal combustible cigarette smoking | Frequency of e-cigarette use (daily or less than daily use)
• Primary outcomes
  • Preterm birth
  • Small for gestational age (SGA)
  • Low birth weight (LBW)

RESULTS:

• 79,176 individuals with a live birth
• Use of e-cigarettes
  • 3 months before pregnancy: 2.7% (95% CI, 2.6 to 2.9)
  • During last 3 months of pregnancy: 1.1% (95% CI, 1.0 to 1.2%)
• E-cigarette use before pregnancy was not associated with adverse birth outcomes
• Using e-cigarettes during pregnancy was associated with increased prevalence of LBW
  • Non-use: 6.1%
  • Use during pregnancy: 6.1%
  • Adjusted prevalence ratio 1.33 (95% CI, 1.06 to 1.66)
• Among respondents who did not smoke combustible cigarettes during pregnancy, e-cigarette use was associated with a higher prevalence of
  • LBW: 10.6%
    • Adjusted prevalence ratio 1.88 (95% CI, 1.38 to 2.57)
  • Preterm birth: 12.4%
    • Adjusted prevalence ratio 1.69 (95% CI, 1.20 to 2.39)
• Stratification by frequency
  •  Associations were seen only for daily users

CONCLUSION:

• Use of e-cigarettes during pregnancy was associated with LBW and preterm birth
• Associations were especially pronounced among daily e-cigarettes users who were not also smoking combustible cigarettes
• The authors state

…pregnant individuals should be directed toward evidence-based cessation strategies (eg, quitlines, cessation counseling, medications)

Results from this study further support guidance by the CDC stating that e-cigarettes are not safe to use during pregnancy

Learn More – Primary Sources:

Adverse Birth Outcomes Associated With Prepregnancy and Prenatal Electronic Cigarette Use

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