Associations between electronic nicotine delivery systems and birth outcomes

Area of Science:

• Public Health
• Reproductive Health
• Perinatal Research

Background:

• Nicotine is a known teratogen that crosses the placenta.
• Electronic nicotine delivery systems (ENDS) use is increasing among pregnant women in the US.
• Limited data exists on the impact of ENDS on birth outcomes.

Purpose of the Study:

• To examine the association between ENDS use and cigarette use during pregnancy with birth outcomes.
• To investigate the effects of exclusive ENDS use and dual use on infant health.
• To inform public health strategies regarding substance use during pregnancy.

Main Methods:

• Cross-sectional analysis of 57,046 respondents from the 2016-2017 Pregnancy Risk Assessment Monitoring System.
• Self-reported use of ENDS and cigarettes in the last trimester of pregnancy.
• Linked self-reported data with birth certificate outcomes (birth weight, gestational age, SGA, preterm birth).

Main Results:

• 0.5% used ENDS only, 0.8% dual users, 8.0% cigarettes only.
• Infants of ENDS-only users weighed 57.8g less and were born 0.21 weeks earlier (not statistically significant).
• Infants of dual users weighed 193.9g less and had 1.93x higher odds of being small-for-gestational age (p < .01).

Conclusions:

• Prenatal ENDS use may adversely affect birth outcomes, reducing birth weight and gestational age.
• Estimates for ENDS-only use were imprecise.
• Larger sample sizes and detailed use patterns are needed to confirm findings.