Vaping and Smoking in Pregnancy-A Meta-Analysis of Neurobehavioural Development in Prenatally Exposed Offspring

Electronic cigarette usage has become increasingly popular in recent years, advertised as a safe alternative to smoking. However, the long-term impact on prenatal development is not well understood. The aim of this systematic review and meta-analysis is to investigate the impact of prenatal electronic cigarette exposure on self-regulation and motor development in existing human and animal research and to identify the common assessment measures.

2116 records from six databases were retrieved, of which 70 (56 human; 14 animal) were retained for review. Random-effects meta-analyses were conducted on eligible studies.

The emerging animal literature provides evidence for the impact of electronic cigarette exposure on offspring development. Meta-analysis results of 42 eligible human studies indicated that prenatal exposure to nicotine or cannabis by combustible or electronic cigarette was associated with deficits in cognitive, emotional, and behavioural self-regulatory domains, as well as motor function and neuromotor development. Only one human study included electronic cigarettes.

The combined findings of human and animal literature suggest overlapping influences of combustible and electronic cigarettes across self-regulation and motor domains. Given the policy implications, there is an urgent need for more research on electronic cigarette use in humans during pregnancy.