Related Experiment Video
Updated: May 25, 2026
Generation of Electronic Cigarette Aerosol by a Third-Generation Machine-Vaping Device: Application to Toxicological Studies
Published on: August 25, 2018
Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and
Samantha Johnstone1, Ashley Schenkel1, Samantha Canazzi1
1Department of Psychology, State University of New York at Buffalo, Buffalo, NY 14260, United States.
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.
More Related Videos
10:44Comparing the Effects of Electronic Cigarette Vapor and Cigarette Smoke in a Novel In Vivo Exposure System
Published on: May 24, 2017
09:30A Microcontroller Operated Device for the Generation of Liquid Extracts from Conventional Cigarette Smoke and Electronic Cigarette Aerosol
Published on: January 18, 2018
Related Concept Videos
01:29Stimulants
Cocaine can be administered via snorting, injection, or smoking. It primarily functions by blocking the reuptake of dopamine, resulting in a euphoric high characterized by an intense sensation of happiness and...
01:23Drugs Acting on Autonomic Ganglia: Stimulants
Ganglionic stimulants activate NM nicotinic receptors in autonomic ganglia, falling into two categories: nicotine mimetics [e.g., lobeline, dimethylpiperazine, tetramethylammonium] and muscarinic receptor agonists [e.g., muscarine, methacholine]. The first category's action is rapid and blocked by nicotinic receptor antagonists, while the second category's action is delayed and blocked by atropine-like agents. Nicotine, an alkaloid, affects the heart rate by stimulating sympathetic or...
01:21Intrauterine Drug Delivery Systems