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Cited by 33Smoking Behavior and CessationPrenatal Substance Exposure EffectsPregnancy and Medication Impact

Birth Outcomes Associated With E-Cigarette and Non–E-Cigarette Tobacco Product Use During Pregnancy: An Examination of PATH Data Waves 1–5

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Cohn, Amy M, Elmasry, Hoda, Wild, Robert C, Johnson, Amanda L, Abudayyeh, Haneen, Kurti, Allison, Coleman-Cowger, Victoria H·2023·Nicotine & Tobacco Research
DOI 10.1093/ntr/ntac111PMC PMC9910157
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Abstract

Objectives: To examine associations of prenatal e-cigarette use to pregnancy and birth outcomes. Methods: Currently pregnant women (n = 1 037) from Waves 1 through 4 of the Population Assessment of Tobacco and Health Study who had pregnancy or live birth outcome data in a subsequent wave (Waves 2–5; 2013 to 2019). Weighted bivariate and multivariable models\ examined associations between past 30-day tobacco use assessed during pregnancy (any past 30-day e-cigarette use, any past 30-day non–e-cigarette tobacco use, or no past 30-day tobacco use) with adverse pregnancy (miscarriage, abortion, ectopic or tubal pregnancy, stillbirth) and birth outcomes (preterm birth, low birth weight, birth defect, placenta previa, placental abruption, pre-eclampsia) reported in the subsequent wave. Results: Approximately 1% of pregnant women reported past 30-day exclusive e-cigarette use and 3.2% used e-cigarettes and one other tobacco product. Compared to no tobacco use, past 30-day e-cigarette use (exclusive or use with another tobacco product) during pregnancy was not associated with increased odds of an adverse pregnancy or birth outcome in bivariate or multivariable models. Past 30-day non–e-cigarette tobacco use was associated with increased odds of an adverse pregnancy outcome in multivariable models, but not an adverse live birth outcome. Compared to past 30-day cigarette use, past 30-day e-cigarette use during pregnancy was not associated with lowered odds of a birth or pregnancy outcome. Conclusions: E-cigarette use during pregnancy is rare. Understanding the positive and negative impacts of pre–natal e-cigarette use on women’s health may guide public health messaging campaigns. Implications: Results showed that past 30-day e-cigarette use during pregnancy was low, with cigarette smoking remaining the most prevalent form of tobacco use during pregnancy. Current e-cigarette use during pregnancy used either exclusively or with another tobacco product, was not associated with increased risk of an adverse pregnancy, or birth outcome. A small sample size of e-cigarette users and limited information on quantity and frequency of e-cigarette use before and during pregnancy may limit conclusions. Healthcare providers may use this information when discussing the harms and consequences associated with e-cigarette and tobacco use during pregnancy.

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  • Three studies included all vapers without controlling for smoking status and were rated zero because smoking is likely to be the most important confounder.

    “For the criterion ‘Were appropriate confounders accounted for in the design and analysis?’, three studies included all vapers without controlling for smoking status and therefore were rated as zero [38, 51, 56] as smoking is likely to be the most important confounder.”

    From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [38]

  • In 17 studies it was not assessed whether any of those counted as vaping used non-nicotine vapes.

    “and in 17 studies it was not assessed whether any of those counted as vaping used non-nicotine vapes [32, 35, 36, 38, 42, 43, 45, 46, 48–56].”

    From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [38]

  • Two studies included pregnancy outcomes in a composite measure.

    “In addition, two studies included pregnancy outcomes in a composite measure [38, 45]”

    From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [38]

  • Two 'PATH' studies reported no significant difference in composite measures of adverse birth outcomes for a combination of exclusive-vapers and dual-users compared with non-users.

    “Two ‘PATH’ studies reported no significant difference in composite measures of adverse birth outcomes for a combination of exclusive-vapers and dual-users compared with non-users [38, 45], (one study did not control for smoking status [38]) and another found no difference for such a composite when comparing babies of exclusive-vapers, exclusive-smokers, dual-users and non-users, as a whole [47].”

    From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [38]

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Authors
Cohn, A. M., Elmasry, H., Wild, R. C., Johnson, A. L., Abudayyeh, H., Kurti, A., & Coleman-Cowger, V. H.
Affiliations
  • OU Health Stephenson Cancer Center (US)
  • Independent Researcher , Ashburn, VA , USA
  • ERPi , Merrifield, VA , USA
  • University of Vermont (US)
  • The Emmes Company, LLC , Rockville, MD , USA
Corresponding author
Cohn, Amy M
ORCID
Venue
Nicotine & Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2022-04-26
Volume
25
Issue
3
Pages
444-452
ISSN
  • 1462-2203 (ISSN-L)
  • 1469-994X
DOI
10.1093/ntr/ntac111
PMC
PMC9910157
OpenAlex
W4225013524
Cited by
33
References
42
Citations by year
2026: 5 · 2025: 6 · 2024: 17 · 2023: 3 · 2022: 2
FWCI
4.33
Type
journal article
Language
en
Open access
Licence
Locations
  • Nicotine & Tobacco Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • University of Oklahoma Health Sciences Center
  • National Cancer Institute (P30CA225520)
  • Stephenson Cancer Center (U54DA036114)
  • National Institute on Drug Abuse (P20GM103644)
  • Food and Drug Administration
  • National Institute of General Medical Sciences
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
Keywords
prenatal tobacco use, birth outcomes, adverse pregnancy outcomes, preterm birth, low birth weight, congenital malformations, placenta previa, placental abruption, preeclampsia, stillbirth, miscarriage, cigarette smoking, Population Assessment of Tobacco and Health Study
MeSH terms
Vaping, Female, Humans, Infant, Newborn, Placenta, Pregnancy, Pregnancy Complications, Nicotiana, Tobacco Use Disorder, Premature Birth, Tobacco Products, Tobacco Use, Electronic Nicotine Delivery Systems

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