The DOI matches its Crossref record; 88 of the 88 references it cites were found in a registry or an index; 1 of the 133 sources its claims cite were checked for support.
Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis
Open accessAbstract
Introduction: Despite electronic nicotine delivery systems (ENDS) being used for smoking cessation during pregnancy, the relative consequences are still unclear. Here, we systematically reviewed and meta-analyzed birth outcomes associated with ENDS use. Methods: This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. OVID (MEDLINE, EMBASE, PsycINFO) and PubMed databases were searched from inception until August 2025, for studies comparing outcomes from in utero exclusive ENDS exposure to non-exposed, exclusive nicotine replacement therapy–exposed, or exclusive combustible cigarette (CC)–exposed neonates. Results: We included k = 22 studies with k = 10 independent samples. In ENDS-exposed vs non-exposed births, there were significantly greater odds of preterm birth (k = 3; moderate confidence) but not small for gestational age (SGA; k = 3; low confidence); these findings were less robust to sensitivity analysis. Additionally, there was no significant difference in SGA (k = 3; moderate confidence) or preterm birth (k = 3; high confidence) between CC-exposed and ENDS-exposed neonates; these findings were robust to sensitivity analysis. Analysis of continuous outcomes found lower birthweight in ENDS- vs non-exposed neonates (k = 4; moderate confidence) and lower birthweight in CC- vs ENDS-exposed neonates (k = 4; low confidence), and no difference in gestational age in either comparison (low confidence). Narrative synthesis suggests quitting ENDS was associated with better birth outcomes, and associations between ENDS and delayed development of infant motor maturity and reflexes. Conclusion: ENDS exposure may confer comparable risk as cigarette smoking to preterm birth. Further research is needed given low to moderate confidence in findings and risk of bias conferred by limited classification of exclusive ENDS use. Implications: With respect to adverse birth outcomes, ENDS may constitute a risk compared to no-nicotine exposure, suggesting the importance of investigating vaping cessation interventions, as well as greater research into alternative smoking cessation interventions for people who are pregnant or want to become pregnant.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This systematic review and meta-analysis of 22 studies (10 independent samples) found that exclusive intrauterine ENDS exposure was associated with greater odds of preterm birth and lower birthweight versus no nicotine exposure, but odds of preterm birth and SGA were not significantly different from combustible cigarette exposure. Confidence in most estimates was low to moderate, and the authors conclude ENDS may confer comparable risk to smoking for preterm birth while calling for better exposure measurement and vaping-cessation research.
Key findings
- ENDS-exposed vs non-exposed: significantly greater odds of preterm birth (k = 3; n = 334 vs 56,571; OR = 1.25, 95% CI [1.01, 1.56]; I² = 0%, P = .55), but not SGA (k = 3; n = 988 vs 175,247; OR = 3.48, 95% CI [0.68, 17.76]; I² = 61%, P = .06). The abstract/GRADE narrative reports moderate confidence for preterm birth and low confidence for SGA; Table 1 lists preterm vs non-use as low confidence.
- CC-exposed vs ENDS-exposed: no significant difference in preterm birth (k = 3; n = 1010 vs 15,061; OR = 0.96, 95% CI [0.82, 1.12]; I² = 0%, P = .87; high confidence) or SGA (k = 3; n = 988 vs 14,932; OR = 1.32, 95% CI [0.37, 4.69]; I² = 67.2%, P = .03; moderate confidence).
- Continuous outcomes: lower birthweight in ENDS- vs non-exposed neonates (k = 4; n = 726 vs 29,390; SMD = −94.2, 95% CI [−132.2, −4.79], P < .001; moderate confidence), with no gestational-age difference (k = 5; n = 597 vs 54,460; SMD = 0.8, 95% CI [−0.30, 0.47], P = .65; low confidence). CC- vs ENDS-exposed neonates showed lower birthweight in CC-exposed (k = 4; n = 726 vs 2405; SMD = 223.2, 95% CI [29.6, 416.8], P = .20 as reported; low confidence), with no gestational-age difference (k = 3; n = 232 vs 271; SMD = .39, 95% CI [−0.21, 1.00], P = .20; low confidence).
- Narrative synthesis: quitting ENDS was associated with better birth outcomes in some studies; one study found lower motor maturity and reflexes in ENDS- and CC-exposed infants/toddlers vs non-exposed, with no significant differences between ENDS- and CC-exposed. NRT as a comparator could not be meta-analyzed because only one study assessed it.
Methods
- PRISMA-reported systematic review and meta-analysis pre-registered with PROSPERO (CRD42024584628); searched PubMed, OVID MEDLINE, EMBASE, and PsycINFO in September 2024, March 2025, and August 2025.
- Included original peer-reviewed studies of newborns, infants, or toddlers (0 days to 3 years) with exclusive in utero ENDS exposure compared with no nicotine exposure, exclusive combustible cigarette exposure, or exclusive NRT exposure, on validated birth or neurodevelopmental outcomes; excluded animal models, meta-analyses, and systematic reviews. Included k = 22 studies with k = 10 independent samples.
- Random-effects meta-analysis for binary outcomes using most-adjusted ORs and for continuous outcomes using standardized mean differences, requiring at least three studies per outcome; assessed risk of bias with ROBINS-E/ROBINS-I, GRADE certainty, I² heterogeneity, trim-and-fill, influential-case analyses, and sensitivity analyses substituting PRAMS samples; analyses in R with metafor.
Limitations
- The paper states that ENDS-exposed samples were substantially smaller than non-exposed or cigarette-exposed groups; ENDS exposure was typically poorly quantified (frequency, quantity, and nicotine concentration often unreported), mostly self-report with only five studies using bioverification; exposure classification often relied on last-3-months use and may miss product switching; some ORs were derived from unadjusted cell counts; no included studies investigated co-exposure to alcohol or cannabis; only one study assessed neurodevelopmental outcomes; and most studies had some or high risk of bias.
- The paper states that handling of overlapping PRAMS samples was not pre-registered, and sensitivity analyses substituting PRAMS studies produced inconsistent significance for preterm birth and SGA versus non-exposed.
- Evident in the text: confidence ratings for preterm birth versus non-exposed differ between the abstract/GRADE narrative (moderate) and Table 1 (low), and the CC- vs ENDS-exposed birthweight result reports a confidence interval excluding zero alongside P = .20.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
43 Not checked yet · 39 Own method · 23 Own result · 20 Check pending · 15 Own interpretation · 5 No full text of the sources · 2 Sources not found · 1 Partly supported · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Finally, while nearly all studies collapsed findings across ENDS nicotine concentration, frequency of use, and flavors, one study reported greater risk of adverse outcomes in neonates exposed to mint/menthol-flavor ENDS products compared to other flavors among exclusive and dual ENDS exposure,73”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Partly supportedcites [73] Lin S-y, Wang L, Zhou W, Kitsantas P, Wen X, Xue H. E-cigarette use during pregnancy and its association with adverse birth outcomes in the US. Prev Med. 2023; 166: 107375. 10.1016/j.ypmed.2022.107375. PMC9888444 36481272 sourceExperimental — accuracy not yet measured
The Results report higher odds of fetal death with mint/menthol-flavored e-cigarette use than with other flavors. They do not report this flavor comparison separately for exclusive and dual ENDS exposure, and fetal death is not a neonatal outcome. (LLM, conf=0.88)
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Comparatively, non-epidemiological studies tended to have bioverification of self-report to support exposure classification.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Study characteristics
hedgedstates an associationn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In addition, one treatment study58,75 compared ENDS to NRT for smoking cessation during pregnancy and found greater smoking cessation in participants randomized to ENDS; intention-to-treat (ITT) analysis revealed greater odds of LBW in neonates of NRT-treated mothers compared to ENDS-treated mothers.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [58] Hajek P, Przulj D, Pesola F, et al. Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial. Nat Med. 2022; 28: 958– 964. 10.1038/s41591-022-01808-0. PMC9117131 35577966 source
- Not checked — no full text of the sourcecites [75] Pesola F, Smith KM, Phillips-Waller A, et al. Safety of e-cigarettes and nicotine patches as stop-smoking aids in pregnancy: secondary analysis of the pregnancy trial of E-cigarettes and patches (PREP) randomized controlled trial. Addiction. 2024; 119: 875– 884. 10.1111/add.16422. 38229538 source
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A check of a cited source is scheduled, or we don’t hold its full text yet; the claim is checked once it runs.
In the paper
“Four studies (k=3 PRAMS samples) found that ENDS-exposed neonates had significantly greater odds of LBW relative to non-exposed neonates and no difference in odds of LBW between ENDS-exposed versus CC-exposed neonates.53,63,67,71”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [53] Ammar L, Tindle HA, Miller AM, et al. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: a cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One. 2023; 18: e0287348. 10.1371/journal.pone.0287348. PMC10597477 37874824 source
A check is scheduled.
- Not checked yetcites [63] Kim S, Oancea SC. Electronic cigarettes may not be a “safer alternative” of conventional cigarettes during pregnancy: evidence from the nationally representative PRAMS data. BMC Pregnancy Childbirth. 2020; 20: 557. 10.1186/s12884-020-03247-6. PMC7510270 32967660 source
A check is scheduled.
- Not checked yetcites [67] Regan AK, Pereira G. Patterns of combustible and electronic cigarette use during pregnancy and associated pregnancy outcomes. Sci Rep. 2021; 11: 13508. 10.1038/s41598-021-92930-5. PMC8241992 34188127 source
A check is scheduled.
plainstates an associationn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not checked yet
In the paper
“and one study that differentiated birth outcomes by frequency of ENDS use found significantly greater adverse birth outcomes (relative to non-exposed) only in those reporting daily use.60”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [60] Regan AK, Bombard JM, O’Hegarty MM, Smith RA, Tong VT. Adverse birth outcomes associated with prepregnancy and prenatal electronic cigarette use. Obstet Gynecol. 2021; 138: 85– 94. 10.1097/AOG.0000000000004432. PMC10896115 34259468 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Comparatively, relative to CC use, there was not a significant difference in odds of preterm birth and SGA”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The included studies' exposure classifications (e.g., product used in the last 3 months of pregnancy) adequately represent intrauterine ENDS/CC exposure for the meta-analyses.
A check of a cited source is scheduled, or we don’t hold its full text yet; the claim is checked once it runs.
In the paper
“Four studies (k=3 PRAMS samples) found that ENDS-exposed neonates had significantly greater odds of LBW relative to non-exposed neonates and no difference in odds of LBW between ENDS-exposed versus CC-exposed neonates.53,63,67,71”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [53] Ammar L, Tindle HA, Miller AM, et al. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: a cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One. 2023; 18: e0287348. 10.1371/journal.pone.0287348. PMC10597477 37874824 source
A check is scheduled.
- Not checked yetcites [63] Kim S, Oancea SC. Electronic cigarettes may not be a “safer alternative” of conventional cigarettes during pregnancy: evidence from the nationally representative PRAMS data. BMC Pregnancy Childbirth. 2020; 20: 557. 10.1186/s12884-020-03247-6. PMC7510270 32967660 source
A check is scheduled.
- Not checked yetcites [67] Regan AK, Pereira G. Patterns of combustible and electronic cigarette use during pregnancy and associated pregnancy outcomes. Sci Rep. 2021; 11: 13508. 10.1038/s41598-021-92930-5. PMC8241992 34188127 source
A check is scheduled.
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not checked yet
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With the initial meta-analyses utilizing the largest PRAMS sample, we found significantly greater odds of preterm birth in ENDS-exposed neonates compared to no nicotine exposure.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The included studies' exposure classifications (e.g., product used in the last 3 months of pregnancy) adequately represent intrauterine ENDS/CC exposure for the meta-analyses.
- Rests on an assumption: The no-nicotine exposure group is unexposed to nicotine.
None of the sources cited for this claim have been checked yet.
In the paper
“Three studies (k = 2 PRAMS) reported heavier birthweights and higher gestational age among neonates born to women who quit exclusive ENDS use compared to those who continued to use,53,67,74 whereas one study found that quitting ENDS was not associated with better outcomes.73”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [53] Ammar L, Tindle HA, Miller AM, et al. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: a cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One. 2023; 18: e0287348. 10.1371/journal.pone.0287348. PMC10597477 37874824 source
- Not checked yetcites [67] Regan AK, Pereira G. Patterns of combustible and electronic cigarette use during pregnancy and associated pregnancy outcomes. Sci Rep. 2021; 11: 13508. 10.1038/s41598-021-92930-5. PMC8241992 34188127 source
- Not checked yetcites [74] Ashford K, McCubbin A, Barnett J, et al. Longitudinal examination of prenatal tobacco switching Behaviors and birth outcomes, including electronic nicotine delivery system (ENDS) and dual use. Matern Child Health J. 2021; 25: 1175– 1181. 10.1007/s10995-021-03161-z. PMC8314381 33973130 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In addition, one treatment study58,75 compared ENDS to NRT for smoking cessation during pregnancy and found greater smoking cessation in participants randomized to ENDS; intention-to-treat (ITT) analysis revealed greater odds of LBW in neonates of NRT-treated mothers compared to ENDS-treated mothers.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [58] Hajek P, Przulj D, Pesola F, et al. Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial. Nat Med. 2022; 28: 958– 964. 10.1038/s41591-022-01808-0. PMC9117131 35577966 source
- Not checked — no full text of the sourcecites [75] Pesola F, Smith KM, Phillips-Waller A, et al. Safety of e-cigarettes and nicotine patches as stop-smoking aids in pregnancy: secondary analysis of the pregnancy trial of E-cigarettes and patches (PREP) randomized controlled trial. Addiction. 2024; 119: 875– 884. 10.1111/add.16422. 38229538 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 54
- Probably not a substantial claim. 39
None of the sources cited for this claim have been checked yet.
In the paper
“Among the k = 3 independent samples with preterm birth as an outcome,59-61 the risk of preterm birth was significantly greater in ENDS-exposed (n = 334) vs non-exposed (n = 56 571) births (OR = 1.25, 95% CI [1.01, 1.56]; see Figure 2) and the index of between-study heterogeneity was not significant (I2 = 0%, P = .55).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [59] Opondo C, Harrison S, Alderdice F, Carson C, Quigley MA. Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England. PLoS One. 2021; 16: e0252817. 10.1371/journal.pone.0252817. PMC8177470 34086809 source
- Not checked yetcites [60] Regan AK, Bombard JM, O’Hegarty MM, Smith RA, Tong VT. Adverse birth outcomes associated with prepregnancy and prenatal electronic cigarette use. Obstet Gynecol. 2021; 138: 85– 94. 10.1097/AOG.0000000000004432. PMC10896115 34259468 source
- Not checked yetcites [61] Nanninga EK, Weiland S, Berger MY, Feijen-de Jong EI, Erwich JJHM, Peters LL. Adverse maternal and infant outcomes of women who differ in smoking status: E-cigarette and tobacco cigarette users. Int J Environ Res Public Health. 2023; 20: 2632. 10.3390/ijerph20032632. PMC9915204 36768007 source
plainstates an associationn = 334 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Among k = 3 independent samples with SGA as an outcome,53,57,61 the odds of SGA were not significantly greater for ENDS-exposed (n = 988) compared to non-exposed (n = 175 247) neonates (OR = 3.48 [0.68, 17.76]; see Figure 2), and the test for heterogeneity was not significant (I2 = 61%, P = .06).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [53] Ammar L, Tindle HA, Miller AM, et al. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: a cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One. 2023; 18: e0287348. 10.1371/journal.pone.0287348. PMC10597477 37874824 source
- Not checked yetcites [57] Cardenas VM, Cen R, Clemens MM, et al. Use of electronic nicotine delivery systems (ENDS) by pregnant women I: risk of small-for-gestational-age birth. Tob Induc Dis. 2019; 17: 44. 10.18332/tid/106089. PMC6662791 31516487 source
- Not checked yetcites [61] Nanninga EK, Weiland S, Berger MY, Feijen-de Jong EI, Erwich JJHM, Peters LL. Adverse maternal and infant outcomes of women who differ in smoking status: E-cigarette and tobacco cigarette users. Int J Environ Res Public Health. 2023; 20: 2632. 10.3390/ijerph20032632. PMC9915204 36768007 source
plainn = 988- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Notably, where reported, most studies included a range of ENDS exposure frequency (ie, from a few times a month to multiple times a day), whereas cigarette exposure tended to be daily, indicating variability in exposure.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Study characteristics
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We included k = 22 studies with k = 10 independent samples.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Abstract > Results
plainn = 10- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Among the k = 3 independent samples with SGA as an outcome,53,57,61 there was also no significant difference in odds of SGA between ENDS (n = 988) compared to CC (n = 14 932) exposed (OR = 1.32, 95% CI [0.37, 4.69]; see Figure 3). However, there was significant between-study heterogeneity (I2 = 67.2, P = .03).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [53] Ammar L, Tindle HA, Miller AM, et al. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: a cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One. 2023; 18: e0287348. 10.1371/journal.pone.0287348. PMC10597477 37874824 source
- Not checked yetcites [57] Cardenas VM, Cen R, Clemens MM, et al. Use of electronic nicotine delivery systems (ENDS) by pregnant women I: risk of small-for-gestational-age birth. Tob Induc Dis. 2019; 17: 44. 10.18332/tid/106089. PMC6662791 31516487 source
- Not checked yetcites [61] Nanninga EK, Weiland S, Berger MY, Feijen-de Jong EI, Erwich JJHM, Peters LL. Adverse maternal and infant outcomes of women who differ in smoking status: E-cigarette and tobacco cigarette users. Int J Environ Res Public Health. 2023; 20: 2632. 10.3390/ijerph20032632. PMC9915204 36768007 source
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“We found k = 5 studies59,62,68–70 that assessed gestational age and found there was no significant difference between ENDS-exposed (n = 597) vs non-exposed (n = 54 460) neonates (SMD = 0.8, [−0.30, 0.47], P = .65; see Figure 4). The test for heterogeneity was not significant (I2 = 0.0, P = .25).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [59] Opondo C, Harrison S, Alderdice F, Carson C, Quigley MA. Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England. PLoS One. 2021; 16: e0252817. 10.1371/journal.pone.0252817. PMC8177470 34086809 source
- Not checked — no full text of the sourcecites [62] Hawkins SS, Wylie BJ, Hacker MR. Associations between electronic nicotine delivery systems and birth outcomes. J Matern Fetal Neonatal Med. 2022; 35: 6868– 6875. 10.1080/14767058.2021.1929156 published Online First: 20210524. 34030564 source
- Not checked yetcites [68] Froggatt S, Reissland N, Covey J. The effects of prenatal cigarette and e-cigarette exposure on infant neurobehaviour: a comparison to a control group. EClinicalMedicine. 2020; 28: 100602. 10.1016/j.eclinm.2020.100602. PMC7700948 33294816 source
- Not checked — no full text of the sourcecites [69] McDonnell BP, Dicker P, Regan CL. Electronic cigarettes and obstetric outcomes: a prospective observational study. BJOG Int J Obstet Gynaecol. 2020; 127: 750– 756. 10.1111/1471-0528.16110. 32036628 source
- Check pendingcites [70] Bailey BA, Azar M, Nadolski K, Dodge P. Fetal growth following electronic cigarette use in pregnancy. Int J Environ Res Public Health. 2024; 21: 1179. 10.3390/ijerph21091179. PMC11431261 39338062 source
plainn = 597- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In one PRAMS sample, ENDS use increased among pregnant adolescents from 0.8% to 4.1% between 2016 and 2021.52”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Study characteristics
What the sources say
- Check pendingcites [52] Wen X, Liu L, Moe AA, et al. Use of E-cigarettes and cigarettes during late pregnancy among adolescents. JAMA Netw Open. 2023; 6: e2347407– e2347407. 10.1001/jamanetworkopen.2023.47407. PMC10719752 38091042 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Among the k = 3 independent samples with preterm birth as an outcome,53,59,61 the odds of preterm birth between ENDS-exposed (n = 1010) and CC-exposed (n = 15 061) neonates was not significant (OR = 0.96, 95% CI [0.82, 1.12]; see Figure 3). Between-study heterogeneity was not significant (I2 = 0%, P = .87).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [53] Ammar L, Tindle HA, Miller AM, et al. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: a cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One. 2023; 18: e0287348. 10.1371/journal.pone.0287348. PMC10597477 37874824 source
- Not checked yetcites [59] Opondo C, Harrison S, Alderdice F, Carson C, Quigley MA. Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England. PLoS One. 2021; 16: e0252817. 10.1371/journal.pone.0252817. PMC8177470 34086809 source
- Not checked yetcites [61] Nanninga EK, Weiland S, Berger MY, Feijen-de Jong EI, Erwich JJHM, Peters LL. Adverse maternal and infant outcomes of women who differ in smoking status: E-cigarette and tobacco cigarette users. Int J Environ Res Public Health. 2023; 20: 2632. 10.3390/ijerph20032632. PMC9915204 36768007 source
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Indeed, k = 5 sample-level studies used biological markers of exposure data; critically, one study that employed biomarkers of nicotine exposure with hair nicotine, salivary cotinine, and exhaled CO found substantial non-reporting of ENDS and smoking exposure (24% and 12%, respectively57), suggesting comparison of nicotine product groups through only self-report may be affected by self-reporting b”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Study characteristics
What the sources say
- Not checked yetcites [57] Cardenas VM, Cen R, Clemens MM, et al. Use of electronic nicotine delivery systems (ENDS) by pregnant women I: risk of small-for-gestational-age birth. Tob Induc Dis. 2019; 17: 44. 10.18332/tid/106089. PMC6662791 31516487 source
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper states — it cites no source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, all studies investigating both cigarettes and ENDS reported a higher prevalence of smoking during pregnancy versus ENDS use.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Study characteristics
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Two PATH studies covering the same years of data collection (2013–2018) assessed adverse birth outcomes, which included preterm birth, LBW, birth defects, placenta previa, placenta abruption, and pre-eclampsia and found no significant differences between ENDS exposed and non-exposed or CC-exposed neonates.72,73”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [72] Cohn AM, Elmasry H, Wild RC, et al. Birth outcomes associated with E-cigarette and non-E-cigarette tobacco product use during pregnancy: an examination of PATH data waves 1-5. Nicotine Tob Res. 2023; 25: 444– 452. 10.1093/ntr/ntac111. PMC9910157 35474136 source
- Not checked yetcites [73] Lin S-y, Wang L, Zhou W, Kitsantas P, Wen X, Xue H. E-cigarette use during pregnancy and its association with adverse birth outcomes in the US. Prev Med. 2023; 166: 107375. 10.1016/j.ypmed.2022.107375. PMC9888444 36481272 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In k = 3 studies59,68,69 that assessed gestational age, there was no significant difference between ENDS-exposed (n = 232) and CC–exposed (n = 271) neonates (SMD = .39, [−0.21, 1.00], P = .20; see Figure 5); the test for heterogeneity was not significant (I2 = 58.9, P = .08).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [59] Opondo C, Harrison S, Alderdice F, Carson C, Quigley MA. Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England. PLoS One. 2021; 16: e0252817. 10.1371/journal.pone.0252817. PMC8177470 34086809 source
- Not checked yetcites [68] Froggatt S, Reissland N, Covey J. The effects of prenatal cigarette and e-cigarette exposure on infant neurobehaviour: a comparison to a control group. EClinicalMedicine. 2020; 28: 100602. 10.1016/j.eclinm.2020.100602. PMC7700948 33294816 source
- Not checked — no full text of the sourcecites [69] McDonnell BP, Dicker P, Regan CL. Electronic cigarettes and obstetric outcomes: a prospective observational study. BJOG Int J Obstet Gynaecol. 2020; 127: 750– 756. 10.1111/1471-0528.16110. 32036628 source
plainn = 232- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In addition, we found k = 4 studies59,68,69,71 that assessed birthweight in ENDS-exposed (n = 726) vs non-exposed (n = 29 390) neonates. There was significantly lower weight in grams at birth among ENDS-exposed neonates (SMD = −94.2, 95% CI [−132.2, −4.79], P < .001; see Figure 4). The test for heterogeneity was not significant (I2 = 0.0, p = .25).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [59] Opondo C, Harrison S, Alderdice F, Carson C, Quigley MA. Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England. PLoS One. 2021; 16: e0252817. 10.1371/journal.pone.0252817. PMC8177470 34086809 source
- Not checked yetcites [68] Froggatt S, Reissland N, Covey J. The effects of prenatal cigarette and e-cigarette exposure on infant neurobehaviour: a comparison to a control group. EClinicalMedicine. 2020; 28: 100602. 10.1016/j.eclinm.2020.100602. PMC7700948 33294816 source
- Not checked — no full text of the sourcecites [69] McDonnell BP, Dicker P, Regan CL. Electronic cigarettes and obstetric outcomes: a prospective observational study. BJOG Int J Obstet Gynaecol. 2020; 127: 750– 756. 10.1111/1471-0528.16110. 32036628 source
plainstates an associationn = 726 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In k = 4 studies59,68,69,71 that assessed birthweight in ENDS-exposed (n = 726) vs CC-exposed (n = 2405) neonates, ENDS-exposed neonates were significantly heavier at birth (SMD = 223.2, [29.6, 416.8], P = .20; see Figure 5). The test for heterogeneity was significant (I2 = 83.5, P < .001).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [59] Opondo C, Harrison S, Alderdice F, Carson C, Quigley MA. Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England. PLoS One. 2021; 16: e0252817. 10.1371/journal.pone.0252817. PMC8177470 34086809 source
- Not checked yetcites [68] Froggatt S, Reissland N, Covey J. The effects of prenatal cigarette and e-cigarette exposure on infant neurobehaviour: a comparison to a control group. EClinicalMedicine. 2020; 28: 100602. 10.1016/j.eclinm.2020.100602. PMC7700948 33294816 source
- Not checked — no full text of the sourcecites [69] McDonnell BP, Dicker P, Regan CL. Electronic cigarettes and obstetric outcomes: a prospective observational study. BJOG Int J Obstet Gynaecol. 2020; 127: 750– 756. 10.1111/1471-0528.16110. 32036628 source
plainstates an associationn = 726- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“in the present review, only one article (with a small sample size and limited assessment of exposure) investigated infant/toddler neurodevelopmental outcomes.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Findings suggest significantly worse motor maturity and reflexes and possibly greater difficulty with emotion regulation”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“there was no significant difference in high-risk birth or fetal death between ITT groups, or compared to those who were completely abstinent from nicotine.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
What the sources say
- Not checked yetcites [58] Hajek P, Przulj D, Pesola F, et al. Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial. Nat Med. 2022; 28: 958– 964. 10.1038/s41591-022-01808-0. PMC9117131 35577966 source
- Not checked — no full text of the sourcecites [75] Pesola F, Smith KM, Phillips-Waller A, et al. Safety of e-cigarettes and nicotine patches as stop-smoking aids in pregnancy: secondary analysis of the pregnancy trial of E-cigarettes and patches (PREP) randomized controlled trial. Addiction. 2024; 119: 875– 884. 10.1111/add.16422. 38229538 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper states — it cites no source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“most studies assessing ENDS use included participants with use ranging from less than once a week to once a day and compared against cigarette smoking at a rate of 1–41 CPD, limiting the comparability of exposure between ENDS and smoking”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Variation in effect sizes due to heterogeneity (rather than chance) was assessed with I2.54”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
What the sources say
- Not checked yetcites [54] von Hippel PT. The heterogeneity statistic I2 can be biased in small meta-analyses. BMC Med Res Methodol. 2015; 15: 35. 10.1186/s12874-015-0024-z. PMC4410499 25880989 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trim-and-fill analysis indicated two missing studies, but the 95% CI remained non-significant [0.16, 2.24].”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
hedgedn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Only one study also assessed infants at 1 month old; therefore, we could not meta-analyze neurodevelopmental outcomes.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Study characteristics
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“When substituting the Ammar et al. PRAMS study with the other PRAMS sample studies, the risk of preterm birth remained significantly higher in two of the other models (53OR = 1.50 [1.16, 1.94]62; OR = 1.51 [1.07, 2.12]) but not with the remaining three models (63OR = 1.59 [0.81, 3.11]64; OR = 1.07, [0.50, 2.26])65; OR = 1.13 [0.63, 2.02].”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [53] Ammar L, Tindle HA, Miller AM, et al. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: a cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One. 2023; 18: e0287348. 10.1371/journal.pone.0287348. PMC10597477 37874824 source
- Not checked — no full text of the sourcecites [62] Hawkins SS, Wylie BJ, Hacker MR. Associations between electronic nicotine delivery systems and birth outcomes. J Matern Fetal Neonatal Med. 2022; 35: 6868– 6875. 10.1080/14767058.2021.1929156 published Online First: 20210524. 34030564 source
- Not checked yetcites [63] Kim S, Oancea SC. Electronic cigarettes may not be a “safer alternative” of conventional cigarettes during pregnancy: evidence from the nationally representative PRAMS data. BMC Pregnancy Childbirth. 2020; 20: 557. 10.1186/s12884-020-03247-6. PMC7510270 32967660 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, studies were considered to have some risk of bias in classification of exposure when there was limited coverage of assessing exposure across the gestational period.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Risk of bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The Risk Of Bias In Non-randomized Studies–of Exposure (ROBINS-E) tool was used to assess study bias.49”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
What the sources say
- Not matchedcites [49] Higgins JPT, Morgan RL, Rooney AA, et al. A tool to assess risk of bias in non-randomized follow-up studies of exposure effects (ROBINS-E). Environ Int. 2024; 186:108602. 10.1016/j.envint.2024.108602. PMC11098530 38555664
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Likelihood log-ratio plots for all models determined that all parameters were identifiable.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Ammar et al.53 was considered influential.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [53] Ammar L, Tindle HA, Miller AM, et al. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: a cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One. 2023; 18: e0287348. 10.1371/journal.pone.0287348. PMC10597477 37874824 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“relevant covariates were specified a priori: maternal age, maternal race/ethnicity, prenatal care/healthcare, socioeconomic status, and alcohol or cannabis use.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There was a high degree of variability among studies with respect to classification of exposure, with k = 8 PRAMS studies defining exclusive use in the last 3 months of gestation and the remaining PRAMS studies defining exclusive use in the 3 months prior to and last 3 months during gestation, and k = 2 assessing use in the past 30 days at survey completion.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Handling of PRAMS samples was not pre-registered as the amount of overlapping data was not anticipated.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Studies were considered to have a high risk of bias if they did not exclude or control for other substance use, as well as other predetermined covariates (eg, socioeconomic status).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Risk of bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“This systematic review and meta-analysis approach was pre-registered with PROSPERO (CRD42024584628) and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA).46”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
What the sources say
- Not checked yetcites [46] Page MJ, McKenzie JE, Bossuyt PM, et al. Statement: an updated guideline for reporting systematic reviews. BMJ. 2020; 372: n71. 10.1136/bmj.n71. PMC8005924 33782057 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Influential case analyses assessed study outliers through externally standardized residuals, “difference in fit” values, Cook’s distance, covariance, leave-out heterogeneity, hat values, and weights.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“One intervention study was identified and evaluated Risk of Bias In Non-randomized Studies–of Intervention (ROBINS-I),50”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
What the sources say
- Not checked yetcites [50] Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016; 355: i4919. 10.1136/bmj.i4919. PMC5062054 27733354 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trim-and-fill analysis indicated zero missing studies.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
hedgedn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trim-and-fill analysis indicated two missing studies, and the 95% CI remained non-significant [0.17, 6.50].”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
hedgedn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“After reaching 100% agreement on two initial article assessments, bias assessments were conducted independently by A.S. and S.C.; all assessments were reviewed by S.J.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Opondo et al.59 was considered influential.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [59] Opondo C, Harrison S, Alderdice F, Carson C, Quigley MA. Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England. PLoS One. 2021; 16: e0252817. 10.1371/journal.pone.0252817. PMC8177470 34086809 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trim-and-fill analysis indicated two missing studies, when the 95% CI was re-estimated it remained significant [1.18, 1.98].”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
plainstates an associationn = 334- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Three raters independently screened studies for eligibility (S.J., S.C., A.S.) based on title and abstract content followed by a full-text review of each text by S.C. and A.S.; any disagreements were resolved by discussion with S.J.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Trim-and-fill methods assessed publication bias and the potential effect of missing studies on confidence intervals.55”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Materials and methods
What the sources say
- Not checked — no full text of the sourcecites [55] Duval S, Tweedie R. Trim and fill: a simple funnel-plot–based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000; 56: 455– 463. 10.1111/j.0006-341X.2000.00455.x. 10877304 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Most of the included studies were determined to have some concerns or high risk of bias by the ROBINS-E and ROB-2 and one study as a very high risk of bias.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Risk of bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“When substituting with the other PRAMS sample studies, the risk of SGA was significantly higher in two models (63OR = 4.02, [1.10, 14.61]64; OR = 4.49 [1.53, 13.18]) but not with the other models (60OR = 3.55 [0.72, 17.53]62; OR = 3.35 [0.59, 18.92]65; OR = 3.69, [0.78, 17.53]66; OR = 3.76, [0.91, 15.60]).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [63] Kim S, Oancea SC. Electronic cigarettes may not be a “safer alternative” of conventional cigarettes during pregnancy: evidence from the nationally representative PRAMS data. BMC Pregnancy Childbirth. 2020; 20: 557. 10.1186/s12884-020-03247-6. PMC7510270 32967660 source
- Not checked — no full text of the sourcecites [64] Wang X, Lee NL, Burstyn I. Smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a 2016 U.S. national sample. Prev Med. 2020; 134: 106041. 10.1016/j.ypmed.2020.106041. 32105682 source
- Not checked yetcites [60] Regan AK, Bombard JM, O’Hegarty MM, Smith RA, Tong VT. Adverse birth outcomes associated with prepregnancy and prenatal electronic cigarette use. Obstet Gynecol. 2021; 138: 85– 94. 10.1097/AOG.0000000000004432. PMC10896115 34259468 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All studies reported birth outcomes from either birth certificates or medical records.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“When substituting with four of the other PRAMS sample studies, the difference in odds of SGA remained non-significant.62-64,67 When substituting with one of the other PRAMS studies, the odds of SGA were significantly higher in ENDS exposed versus CC-exposed neonates (65OR = 1.60 [1.10, 2.34]).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked — no full text of the sourcecites [62] Hawkins SS, Wylie BJ, Hacker MR. Associations between electronic nicotine delivery systems and birth outcomes. J Matern Fetal Neonatal Med. 2022; 35: 6868– 6875. 10.1080/14767058.2021.1929156 published Online First: 20210524. 34030564 source
- Not checked yetcites [63] Kim S, Oancea SC. Electronic cigarettes may not be a “safer alternative” of conventional cigarettes during pregnancy: evidence from the nationally representative PRAMS data. BMC Pregnancy Childbirth. 2020; 20: 557. 10.1186/s12884-020-03247-6. PMC7510270 32967660 source
- Not checked — no full text of the sourcecites [64] Wang X, Lee NL, Burstyn I. Smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a 2016 U.S. national sample. Prev Med. 2020; 134: 106041. 10.1016/j.ypmed.2020.106041. 32105682 source
- Not checked yetcites [67] Regan AK, Pereira G. Patterns of combustible and electronic cigarette use during pregnancy and associated pregnancy outcomes. Sci Rep. 2021; 11: 13508. 10.1038/s41598-021-92930-5. PMC8241992 34188127 source
- Not checked yetcites [65] Wang X, Lee NL, Burstyn I. Exposure-response analysis of the association of maternal smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a national US sample, 2016–2018. Glob Epidemiol. 2022; 4: 100079. 10.1016/j.gloepi.2022.100079. PMC10446111 37637017 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Note that k = 3 studies only included term births.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trim-and-fill analysis indicated two missing studies; the confidence interval remained non-significant [−0.63, 0.63].”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
hedgedn = 232- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Thus, the present meta-analysis builds on the extant literature by improving the accuracy of estimates with our handling of overlapping samples and detailed sensitivity analyses,17 and separate evaluation of multiple neonatal outcomes against CCs and no nicotine use.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction
What the sources say
- Not checked — no full text of the sourcecites [17] Vallée A, Eid M, Feki A, Ayoubi JM. Maternal vaping and pregnancy adverse outcomes: a systematic review and meta-analysis. Women Birth. 2025; 38: 101951. 10.1016/j.wombi.2025.101951. 40651293 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Final ratings for comparisons to non-exposed are low confidence for SGA and moderate confidence for preterm birth; comparisons to CC-exposed are moderate confidence for SGA and high-confidence for preterm birth.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Indeed, animal models suggest nicotine exposure in utero is associated with increased motor activity, hyperactivity, and impairments in attention, learning, and memory in offspring,24 as well as impaired baseline startle reactivity, enhanced sensory motor gating, and increases in anxiety-associated behaviors in adolescent offspring44 and deficits in long-term memory in adult offspring.45”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Animal models of intrauterine electronic nicotine delivery system exposure
What the sources say
- Check pendingcites [24] Zhou S, Rosenthal DG, Sherman S, Zelikoff J, Gordon T, Weitzman M. Physical, Behavioral, and cognitive effects of prenatal tobacco and postnatal Secondhand smoke exposure. Curr Probl Pediatr Adolesc Health Care. 2014; 44: 219– 241. 10.1016/j.cppeds.2014.03.007. PMC6876620 25106748 source
- Check pendingcites [44] Lallai V, Manca L, Sherafat Y, Fowler CD. Effects of prenatal nicotine, THC, or Co-exposure on cognitive Behaviors in adolescent male and female rats. Nicotine Tob Res. 2022; 24: 1150– 1160. 10.1093/ntr/ntac018. PMC9278841 35090174 source
- Check pendingcites [45] Al-Sawalha N, Alzoubi K, Khabour O, et al. Effect of electronic cigarette aerosol exposure during gestation and lactation on learning and memory of adult male offspring rats. Physiol Behav. 2020; 221: 112911. 10.1016/j.physbeh.2020.112911 published Online First: 20200411. PMC7232770 32289318 source
hedgedstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Final ratings for comparisons to non-nicotine exposed are moderate confidence for birthweight and low confidence for gestational age; comparisons to CC-exposed are low confidence for birthweight and gestational age.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Froggatt et al.68 and McDonnell et al.69 were considered influential.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [68] Froggatt S, Reissland N, Covey J. The effects of prenatal cigarette and e-cigarette exposure on infant neurobehaviour: a comparison to a control group. EClinicalMedicine. 2020; 28: 100602. 10.1016/j.eclinm.2020.100602. PMC7700948 33294816 source
- Not checked — no full text of the sourcecites [69] McDonnell BP, Dicker P, Regan CL. Electronic cigarettes and obstetric outcomes: a prospective observational study. BJOG Int J Obstet Gynaecol. 2020; 127: 750– 756. 10.1111/1471-0528.16110. 32036628 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Furthermore, nicotine acts as a vasoconstrictor, reducing delivery of oxygen and nutrition to the fetus in humans.18”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Current evidence of effects of intrauterine nicotine exposure
What the sources say
- Check pendingcites [18] Suter MA, Aagaard KM. The impact of tobacco chemicals and nicotine on placental development. Prenat Diagn. 2020; 40: 1193– 1200. 10.1002/pd.5660. PMC7396310 32010988 source
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Azar et al.71 was considered influential.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Check pendingcites [71] Azar M, Oatey ME, Moniz MH, Bailey BA. Intrapartum electronic cigarette use and birth outcomes: evidence from a population-based study. Int J Environ Res Public Health. 2024; 21: 1449. 10.3390/ijerph21111449. PMC11593741 39595716 source
plainn = 726- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trim-and-fill analysis indicated one missing study, and the confidence interval was no longer significant after estimating the effect [−3.90, 347.6].”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
hedgedn = 726- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Azar et al.71 was considered influential.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Check pendingcites [71] Azar M, Oatey ME, Moniz MH, Bailey BA. Intrapartum electronic cigarette use and birth outcomes: evidence from a population-based study. Int J Environ Res Public Health. 2024; 21: 1449. 10.3390/ijerph21111449. PMC11593741 39595716 source
plainn = 726- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Indeed, prenatal CC exposure has been associated with significantly lower birthweights and preterm birth; these effects have been found to be dose-dependent,1 and quitting smoking during pregnancy is associated with significantly better birth outcomes than continued smoking.20”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Effects of combustible cigarette smoking during pregnancy
What the sources say
- Check pendingcites [1] Banderali G, Martelli A, Landi M, et al. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med. 2015; 13: 327. 10.1186/s12967-015-0690-y. PMC4608184 26472248 source
- Check pendingcites [20] Larsen S, Haavaldsen C, Bjelland EK, Dypvik J, Jukic AM, Eskild A. Placental weight and birthweight: the relations with number of daily cigarettes and smoking cessation in pregnancy. A population study. Int J Epidemiol. 2018; 47: 1141– 1150. 10.1093/ije/dyy110. PMC6124614 29947760 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Final ratings for comparisons to non-exposed are low confidence for SGA and moderate confidence for preterm birth; comparisons to CC-exposed are moderate confidence for SGA and high-confidence for preterm birth.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Prevalence of ENDS use during pregnancy has been increasing,9 potentially in part due to limited knowledge of outcomes associated with intrauterine ENDS exposure.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
What the sources say
- Not checked yetcites [9] Vilcassim MJR, Stowe S, Majumder R, Subramaniam A, Sinkey RG. Electronic cigarette use during pregnancy: is it harmful? Toxics. 2023; 11: 278. 10.3390/toxics11030278 published Online First: 20230318. PMC10058591 36977043
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A statement the paper makes itself — it cites no source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While the literature indicates multiple reproductive toxins present in CCs, existing evidence suggests that nicotine exposure alone negatively affects fetal development, implicating ENDS as a teratogenic risk.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Current evidence of effects of intrauterine nicotine exposure
hedgedstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All domains had some or high risk of bias; SGA analyses were downgraded due to heterogeneity and not meeting the optimal information size criterion.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trim-and-fill analysis indicated two missing studies; the confidence interval remained significant after estimating their effects [−136.0, −60.2].”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
hedgedstates an associationn = 726- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trim-and-fill analysis indicated one missing study; the estimated confidence interval remained non-significant [−0.26, 0.49].”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
hedgedn = 597- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Notably, inhaled nicotine has a rapid cellular uptake31,32 and overall nicotine intake from ENDS may be comparable to that from cigarettes.33”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Animal models of intrauterine electronic nicotine delivery system exposure
What the sources say
- Check pendingcites [31] Stiles MF, Campbell LR, Graff DW, Jones BA, Fant RV, Henningfield JE. Pharmacodynamic and pharmacokinetic assessment of electronic cigarettes, combustible cigarettes, and nicotine gum: implications for abuse liability. Psychopharmacology. 2017; 234: 2643– 2655. 10.1007/s00213-017-4665-y. PMC5548902 28634710 source
- Check pendingcites [32] Stiles MF, Campbell LR, Jin T, Graff DW, Fant RV, Henningfield JE. Assessment of the abuse liability of three menthol Vuse solo electronic cigarettes relative to combustible cigarettes and nicotine gum. Psychopharmacology. 2018; 235: 2077– 2086. 10.1007/s00213-018-4904-x. PMC6015619 29725702 source
- Not checked — no full text of the sourcecites [33] Goldenson NI, Buchhalter AR, Augustson EM, Rubinstein ML, Henningfield JE. Abuse liability assessment of the JUUL system in four flavors relative to combustible cigarette, nicotine gum and a comparator electronic nicotine delivery system among adult smokers. Drug Alcohol Depend. 2020; 217: 108395. 10.1016/j.drugalcdep.2020.108395. 33176942 source
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Nicotine readily crosses the placenta and can independently affect the development of fetal brain tissue1 through a variety of mechanisms.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Current evidence of effects of intrauterine nicotine exposure
What the sources say
- Check pendingcites [1] Banderali G, Martelli A, Landi M, et al. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med. 2015; 13: 327. 10.1186/s12967-015-0690-y. PMC4608184 26472248 source
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies on animal models have found that intrauterine e-cigarette exposure (ie, including other vapor constituents) resulted in reduced birthweight and placental weight, as well as dose-dependent reductions in uterine artery functioning.40,41”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Animal models of intrauterine electronic nicotine delivery system exposure
What the sources say
- Not checked — no full text of the sourcecites [40] Juusela A, Naik VD, Carabulea A, Janeski J, Jiang H, Ramadoss J. 38 impact of gestational E-cigarette aerosols on uterine artery function in rats. Am J Obstet Gynecol. 2024; 230: S29– S30. 10.1016/j.ajog.2023.11.056. source
- Not checked yetcites [41] Orzabal MR, Lunde-Young ER, Ramirez JI, et al. Chronic exposure to e-cig aerosols during early development causes vascular dysfunction and offspring growth deficits. Transl Res. 2019; 207: 70– 82. 10.1016/j.trsl.2019.01.001 published Online First: 20190107. PMC6486852 30653941 source
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Indeed, a 2018 report by the US National Academies of Sciences (NASEM) stated that there was no available evidence regarding ENDS and pregnancy outcomes and that the evidence on fetal development was insufficient.8”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction
What the sources say
- Not matchedcites [8] National Academies of Sciences E, Medicine. Public Health Consequences of e-Cigarettes. The National Academies Press; 2018. 10.17226/24952. 29894118
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Froggatt et al.68 and Hawkins et al.62 were considered influential.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
What the sources say
- Not checked yetcites [68] Froggatt S, Reissland N, Covey J. The effects of prenatal cigarette and e-cigarette exposure on infant neurobehaviour: a comparison to a control group. EClinicalMedicine. 2020; 28: 100602. 10.1016/j.eclinm.2020.100602. PMC7700948 33294816 source
- Not checked — no full text of the sourcecites [62] Hawkins SS, Wylie BJ, Hacker MR. Associations between electronic nicotine delivery systems and birth outcomes. J Matern Fetal Neonatal Med. 2022; 35: 6868– 6875. 10.1080/14767058.2021.1929156 published Online First: 20210524. 34030564 source
plainn = 597- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A wealth of literature supports that combustible cigarette (CC) smoking during pregnancy has deleterious effects on birth outcomes and childhood neurodevelopmental and behavioral outcomes.1-4”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction
What the sources say
- Check pendingcites [1] Banderali G, Martelli A, Landi M, et al. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med. 2015; 13: 327. 10.1186/s12967-015-0690-y. PMC4608184 26472248 source
- Check pendingcites [2] Black MM, Nair P, Spanier AJ. Dose and timing of prenatal tobacco exposure: threats to early child development. Lancet Respir Med. 2014; 2: 677– 679. 10.1016/S2213-2600(14)70182-1. 25127406 source
- Not matchedcites [3] Health UDo, Services H. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease; 2014.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Check pendingcites [4] Eiden RD, Perry KJ, Ivanova MY, Marcus RC. Prenatal substance exposure. Annual review of. Dev Psychol. 2023; 5: 19– 44. 10.1146/annurev-devpsych-120621-043414. PMC12380384 40874035 source
boostedstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“CC smoking during pregnancy results in exposure to nicotine, the primary psychoactive component of cigarettes, as well as numerous other reproductive toxins and carcinogens, including carbon monoxide (CO), carbon dioxide, and nitric oxide, each of which may affect birth and infant outcomes.18”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Introduction > Effects of combustible cigarette smoking during pregnancy
What the sources say
- Check pendingcites [18] Suter MA, Aagaard KM. The impact of tobacco chemicals and nicotine on placental development. Prenat Diagn. 2020; 40: 1193– 1200. 10.1002/pd.5660. PMC7396310 32010988 source
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“ENDS and CC exposure were grouped based on classifications from included studies, most typically the product used in the last 3 months of pregnancy, either with or without consideration of use in the last 3 months before pregnancy.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion > Limitations and future research
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“although we extracted the models adjusted for the most potentially confounding variables (eg, demographics, other substance use socioeconomic status, prenatal care, and previous smoking), when ORs for the comparisons of interest were not reported, we utilized cell counts, which did not address confounding variables.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion > Limitations and future research
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Notably, delayed or impaired development may be associated with lower birthweight, SGA, and preterm birth.82”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
What the sources say
- Not checked — no full text of the sourcecites [82] Arpino C, Compagnone E, Montanaro ML, et al. Preterm birth and neurodevelopmental outcome: a review. Childs Nerv Syst. 2010; 26: 1139– 1149. 10.1007/s00381-010-1125-y. 20349187 source
hedgedstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“birthweight is predictive of childhood cognitive ability,78”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
What the sources say
- Not checked — no full text of the sourcecites [78] Shenkin SD, Starr JM, Deary IJ. Birth weight and cognitive ability in childhood: a systematic review. Psychol Bull. 2004; 130: 989– 1013. 10.1037/0033-2909.130.6.989. 15535745 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“which may reflect delays in the prefrontal cortex, midbrain, and brainstem regions,83 which may affect future neurodevelopment.84”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
What the sources say
- Not checked yetcites [83] Diamond A. Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex. Child Dev. 2000; 71: 44– 56. 10.1111/1467-8624.00117. 10836557
- Check pendingcites [84] Bowler A, Arichi T, Austerberry C, Fearon P, Ronald A. A systematic review and meta-analysis of the associations between motor milestone timing and motor development in neurodevelopmental conditions. Neurosci Biobehav Rev. 2024; 167: 105825. 10.1016/j.neubiorev.2024.105825. 39067834 source
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, infant/toddler neurocognitive development, specifically motor maturity and reflexes, may be affected by ENDS exposure.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Conclusion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“while some studies employed large sample sizes, others were quite small, and the sample of ENDS-exposed participants was substantially smaller than non-exposed or cigarette-exposed groups, which may have biased results.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion > Limitations and future research
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“which is further associated with occupational prestige, long-term sickness, and educational attainment.79-81”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
What the sources say
- Not checked — no full text of the sourcecites [79] Bukodi E, Erikson R, Goldthorpe JH. The effects of social origins and cognitive ability on educational attainment: evidence from Britain and Sweden. Acta Sociol. 2014; 57: 293– 310. 10.1177/0001699314543803. source
- Not checked — no full text of the sourcecites [80] Cheng H, Furnham A. Childhood cognitive ability, education, and personality traits predict attainment in adult occupational prestige over 17 years. J Vocat Behav. 2012; 81: 218– 226. 10.1016/j.jvb.2012.07.005. source
- Not checked yetcites [81] Schoon I. Childhood cognitive ability and adult academic attainment: evidence from three British cohort studies. Longitud. Life Course Stud. 2010; 1: 241– 258.
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“findings related to NRT and switching behavior could not be meta-analyzed and are limited by small sample sizes”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The findings of this meta-analysis suggest the odds of preterm birth and SGA in ENDS-exposed neonates may be comparable to those associated with cigarette exposure.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Conclusion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“birthweight is considered one of the most important birth outcomes given that it is associated with social and health-related outcomes in childhood and adulthood, including morbidity and mortality.76,77”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
What the sources say
- Not checked — no full text of the sourcecites [76] Baker JL, Olsen LW, Sørensen TI. Weight at birth and all-cause mortality in adulthood. Epidemiology. 2008; 19: 197– 203. 10.1097/EDE.0b013e31816339c6. 18300695 source
- Check pendingcites [77] Class QA, Rickert ME, Lichtenstein P, D'Onofrio BM. Birth weight, physical morbidity, and mortality: a population-based sibling-comparison study. Am J Epidemiol. 2014; 179: 550– 558. 10.1093/aje/kwt304. PMC3927978 24355331 source
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Notably, since NRT was associated with lower odds of cessation, these findings may be explained by greater cigarette exposure throughout pregnancy.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Discussion
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper relies on this without support.
The included studies' study-defined classifications of exclusive ENDS use adequately distinguish exclusive ENDS exposure from other nicotine exposures for the meta-analytic estimates to be valid.
“Note that groups were classified based on study-defined exclusivity, which is detailed in Supplemental Table S1.”
“There was a high degree of variability among studies with respect to classification of exposure, with k = 8 PRAMS studies defining exclusive use in the last 3 months of gestation and the remaining PRAMS studies defining exclusive use in the 3 months prior to and last 3 months during gestation, and k = 2 assessing use in the past 30 days at survey completion.”
The paper relies on this without support.
The included studies' exposure classifications (e.g., product used in the last 3 months of pregnancy) adequately represent intrauterine ENDS/CC exposure for the meta-analyses.
“ENDS and CC exposure were grouped based on classifications from included studies, most typically the product used in the last 3 months of pregnancy, either with or without consideration of use in the last 3 months before pregnancy.”
The paper relies on this without support.
The no-nicotine exposure group is unexposed to nicotine.
“compared to no nicotine exposure”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
“(SMD = −94.2, 95% CI [−132.2, −4.79], P < .001; see Figure 4)”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
Reported -94.2 · recomputed -68.495
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
“Final ratings for comparisons to non-exposed are low confidence for SGA and moderate confidence for preterm birth”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
“Preterm (vs non-use) Rating: Low confidence”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
“(SMD = 0.8, [−0.30, 0.47], P = .65; see Figure 4)”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
Reported 0.8 · recomputed 0.085
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
“Between-study heterogeneity was not significant (I2 = 0%, P = .87).”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
“Preterm (vs CC) Rating: High confidence | Most some-concerns | −1 | High | −1”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
“In k = 3 studies59,68,69 that assessed gestational age, there was no significant difference between ENDS-exposed (n = 232) and CC–exposed (n = 271) neonates”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
“Gestational age (vs CC use) Rating: Low confidence | Most some-concerns | −1 | Low | 0 | Evidence is sufficiently direct | 0 | 2/5 studies met OIS criterion”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Abstract > Results
“there was no significant difference in SGA (k = 3; moderate confidence) or preterm birth (k = 3; high confidence) between CC-exposed and ENDS-exposed neonates; these findings were robust to sensitivity analysis.”
§ Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis > Results > Meta-analytic results
“When substituting with one of the other PRAMS studies, the odds of SGA were significantly higher in ENDS exposed versus CC-exposed neonates (65OR = 1.60 [1.10, 2.34]).”
Citations
Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283
Conducting Meta-Analyses in R with the metafor Package
Viechtbauer, W. (2010) · Journal of Statistical Software · doi:10.18637/jss.v036.i03 · Cited by 20,464
ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions
Sterne, J. A., Hernán, M. A., Reeves, B. C., Savović, J., Berkman, N. D., Viswanathan, M., Henry, D., Altman, D. G., Ansari, M. T., Boutron, I., et al. (2016) · BMJ · doi:10.1136/bmj.i4919 · Cited by 20,329 · cited 1×
“I), 50 which is intended to assess studies that were not blinded.”
Duval, S., & Tweedie, R. (2000) · Biometrics · doi:10.1111/j.0006-341x.2000.00455.x · Cited by 14,099
Public Health Consequences of E-Cigarettes
Board on Population Health and Public Health Practice, Division, H. A. M., & National Academies of Sciences, E. (2018) · National Academies Press eBooks · doi:10.17226/24952 · Cited by 1,594
Diamond, A. D. (2000) · Child Development · doi:10.1111/1467-8624.00117 · Cited by 1,584
The heterogeneity statistic I2 can be biased in small meta-analyses
von Hippel, P. T. (2015) · BMC Medical Research Methodology · doi:10.1186/s12874-015-0024-z · Cited by 1,229
A tool to assess risk of bias in non-randomized follow-up studies of exposure effects (ROBINS-E)
Higgins, J. P. T., Morgan, R. L., Rooney, A. A., Taylor, K. W., Thayer, K. A., Silva, R. A., Lemeris, C., Akl, E. A., Bateson, T. F., Berkman, N. D., et al. (2024) · Environment International · doi:10.1016/j.envint.2024.108602 · Cited by 1,022
Biochemical verification of tobacco use and abstinence: 2019 update
Benowitz, N. L., Bernert, J. T., Foulds, J., Hecht, S. S., Jacob, P., Jarvis, M. J., Joseph, A., Oncken, C., & Piper, M. E. (2020) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntz132 · Cited by 619 · cited 1×
“87 Fourth, although we extracted the models adjusted for the most potentially confounding variables (eg, demographics, other substance use socioeconomic status, prenatal care, and previous smoking ), when ORs for the comparisons of interest were not reported, we utilized cell counts, which did not…”
Motor Development: Embodied, Embedded, Enculturated, and Enabling
Adolph, K. E., & Hoch, J. E. (2019) · Annual Review of Psychology · doi:10.1146/annurev-psych-010418-102836 · Cited by 580
Research works printed but not linked: 4
- Health UDo, Services H, 2014, The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General
- U.S. Department of Health and Human Services, 2001, Women and Smoking: A Report of the Surgeon General: Department of Health and Human Services
- Eaton, 2018, Toxicology of E-Cigarette Constituents
- Schoon, 2010, Childhood cognitive ability and adult academic attainment: evidence from three British cohort studies, 241
Cited by
Sorted by citations
Thinking outside the box to reduce health inequities in prenatal nicotine and tobacco exposure
Genna, N. M. D., Stroud, L. R., & Bar‐Zeev, Y. (2026) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntag158
USO DE CIGARROS ELETRÔNICOS DURANTE A GESTAÇÃO E SUAS IMPLICAÇÕES PARA A SAÚDE MATERNO-FETAL
Cavalcanti, P. L. D. L. E. S., Bervig, S. P., & Lima, R. D. F. (2026) · Revista Brasileira de Saúde · doi:10.22533/at.ed.82082202629103
Metadata
- Authors
- Johnstone, S., Schenkel, A., Canazzi, S., Eiden, R. D., & Hawk, Jr.
- Affiliations
- University at Buffalo, State University of New York (US)
- Pennsylvania State University (US)
- Department of Psychology, State University of New York at Buffalo , Buffalo, NY 14260 ,
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2026-05-23
- Volume
- 28
- Issue
- 10
- Pages
- 1635-1649
- ISSN
- 1462-2203 (ISSN-L)
- 1469-994X
- PMC
- PMC13601957
- OpenAlex
- W7162197577
- Semantic Scholar
- 1b4a629a65c3cfbc3694935406fa95fc01aadd73
- Cited by
- 2
- References
- 88
- Citations by year
- 2026: 2
- FWCI
- 2.14
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Nicotine & Tobacco Research (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Center for Advancing Translational Sciences (UG3 TR004797-02)
- National Cancer Institute (R01 CA266170-01A1)
- National Institutes of Drug Abuse (R01 DA054276-01A1, 3R01DA054276-03S1)
- Canadian Institutes of Health Research Doctoral Foreign Study (202310DFD-513256-DRA-86383)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Keywords
- electronic cigarettes, birth outcomes, preterm birth, small for gestational age, birth weight, combustible cigarettes, nicotine replacement therapy, smoking cessation, infant motor development, prenatal nicotine exposure
- MeSH terms
- Female, Humans, Infant, Newborn, Infant, Small for Gestational Age, Pregnancy, Pregnancy Outcome, Prenatal Exposure Delayed Effects, Smoking Cessation, Premature Birth, Electronic Nicotine Delivery Systems
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-11-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-11-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis. https://app.cochat.ai/papers/10.1093/ntr/ntag118
- The paper
- Johnstone, S., Schenkel, A., Canazzi, S., Eiden, R. D., & Hawk, Jr. (2026). Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis. Nicotine & Tobacco Research. https://doi.org/10.1093/ntr/ntag118
