Vaping during pregnancy and its impact on neonatal outcomes: A systematic review and meta-analysis

BACKGROUND Vaping during pregnancy is becoming more prevalent, with nearly 7% of individuals using e-cigarettes. This increase may result from tobacco companies targeting younger users with e-cigarette marketing, similar to their strategies with traditional tobacco. While e-cigarette use continues to rise, evidence regarding its effects on neonatal outcomes remains inconsistent. AIM To examine research on the connection between vaping during pregnancy and negative neonatal outcomes, exploring the potential adverse effects. METHODS According to PRISMA guidelines, we conducted a thorough review of studies from PubMed/MEDLINE, Google Scholar, Scopus, EMBASE, and Web of Science for eligible studies that reported on vaping during pregnancy and its effects on neonatal outcomes, including low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). We utilized binary random-effects models to estimate pooled odds ratios (OR) and 95% confidence intervals (CI). A P value of ≤ 0.05 was deemed statistically significant. RESULTS A total of 14 studies with 523273 pregnant women were included in the analysis. Of them, 3840 (0.7%) vaped during pregnancy. In comparison to pregnant women who did not vape, neonates born to those who vaped had significantly higher odds of LBW (OR: 1.60; 95%CI: 1.23-2.09; P = 0.0005) and SGA (OR: 1.73; 95%CI: 1.34-2.22; P < 0.0001), as well as higher odds of PTB (OR: 1.95; 95%CI: 0.74-5.14; P = 0.17). CONCLUSION Vaping during pregnancy is significantly associated with adverse neonatal outcomes, LBW, and SGA, emphasizing the potential risks of vaping during pregnancy and highlighting the necessity for public health initiatives to increase awareness and develop preventive strategies.