ArticlePloS one2023
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.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 5 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Birth outcomes following intrauterine exposure to electronic nicotine delivery systems: a systematic review and meta-analysis.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Pooled it
- Electronic Cigarettes and Female Reproduction: A Systematic Review of Experimental and Clinical Evidence.International journal of molecular sciences · 2026Pooled it
- Comparative effects of electronic cigarettes and dual use of electronic and conventional cigarettes on adverse pregnancy outcomes: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Prevalence of dual use of combustible tobacco and E-cigarettes among pregnant smokers: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Vaping during pregnancy: a systematic review of health outcomes.BMC pregnancy and childbirth · 2024Pooled it
- Prenatal anxiety, tobacco use, and infant birth weight: a multilevel analysis of PRAMS data.Archives of women's mental health · 2026Article
- E-cigarette aerosol-induced neurotoxicity during early brain development: mechanisms and outcomes.Pediatric research · 2026Review
- Vaping during pregnancy and its impact on neonatal outcomes: A systematic review and meta-analysis.World journal of clinical pediatrics · 2026Article
- Uterine artery transcriptomic signatures of e-cigarette aerosol exposure in pregnancy.Reproductive toxicology (Elmsford, N.Y.) · 2026Article
- Article
- Vaping during pregnancy and maternal, fetal, and infant health outcomes: A scoping review of human and animal studies.PloS one · 2026Article
- [Incidence of small for gestational age infants among singleton live births and analysis of risk factors].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025Article
- Investigating Pre-pregnancy and Late-Pregnancy E-cigarette Use Exposure and Gestational Diabetes Mellitus.Cureus · 2025Article
- Nicotine in e-cigarette aerosol reduces GABA neuron migration via the α7 nicotinic acetylcholine receptor.Scientific reports · 2025Article
- Pregnancy and Postpartum Effects of Electronic Cigarettes on Maternal Health and Vascular Function in the Fourth Trimester.Cardiovascular toxicology · 2025Article
- Demographic Characteristics, Perinatal Smoking Patterns, and Risk for Neonatal Health Complications Among Pregnant Smokers in the United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundResearch on health effects and potential harms of electronic cigarette (EC) use during pregnancy is limited. We sought to determine the risks of pregnancy EC use on pregnancy-related adverse birth outcomes and assess whether quitting ECs reduces the risks.
methodsWomen with singleton live births who participated in the US Pregnancy Risk Assessment Monitoring System (PRAMS) survey study 2016-2020 were classified into four mutually exclusive groups, by their use of ECs and combustible cigarettes (CCs) during pregnancy: non-use, EC only use, CC only use, and dual use. We determined the risk of preterm birth, low birth weight, and small-for-gestational-age (SGA) by comparing cigarette users to non-users with a modified Poisson regression model adjusting for covariates. In a subset of women who all used ECs prior to pregnancy, we determined whether quitting EC use reduces the risk of preterm birth, low birth weight, and SGA by comparing to those who continued its use. All analyses were weighted to account for the PRAMS survey design and non-response rate.
resultsOf the 190,707 women (weighted N = 10,202,413) included, 92.1% reported cigarette non-use, 0.5% EC only use, 6.7% CC only use, and 0.7% dual use during pregnancy. Compared with non-use, EC only use was associated with a significantly increased risk of preterm birth (adjusted risk ratio [aRR]: 1.29, 95% confidence interval [CI]: 1.00, 1.65) and low birth weight (aRR: 1.38, 95%CI: 1.09, 1.75), but not SGA (aRR: 1.04, 95%CI: 0.76, 1.44). Among 7,877 (weighted N = 422,533) women EC users, quitting use was associated with a significantly reduced risk of low birth weight (aRR: 0.76, 95%CI: 0.62, 0.94) and SGA (aRR: 0.77, 95%CI: 0.62, 0.94) compared to those who continued to use ECs during pregnancy.
conclusionsPregnancy EC use, by itself or dual use with CC, is associated with preterm birth and low birth weight. Quitting use reduces that risk. ECs should not be considered as a safe alternative nor a viable gestational smoking cessation strategy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.