With the popularity of vaping increasing overall, vaping during pregnancy has become more prevalent, often perceived as a safer alternative to traditional cigarette smoking. However, emerging research challenges this perception and raises concerns about its impact on maternal and neonatal health. A newly published systematic review and meta-analysis is the first of its kind to comprehensively assess the relationship between prenatal vaping and adverse perinatal outcomes, revealing a significant link between vaping and increased risks to both mothers and babies. Most notably, the study found that women who vape during pregnancy have a 53% higher likelihood of experiencing adverse maternal outcomes.
The research team conducted an extensive systematic search across MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, PROSPERO, and Google Scholar to identify relevant studies up to July 2024. They selected 23 studies involving a total of 924,376 participants, including 7,552 who reported using e-cigarettes exclusively during pregnancy. Using inverse-variance random-effects meta-analyses, the researchers evaluated key maternal and neonatal outcomes in those exposed to vaping compared to those who were not.
The findings indicated a 53% increase in the odds of adverse maternal outcomes associated with prenatal vaping (odds ratio [OR] 1.53; 95% CI: 1.27–1.85), with particularly strong associations with decreased breastfeeding (OR 0.53; 95% CI: 0.38–0.72) and reduced engagement in adequate prenatal care (OR 0.69; 95% CI: 0.56–0.86). Similarly, neonatal outcomes showed a 53% increased likelihood of adverse effects (OR 1.53; 95% CI: 1.34–1.76), including low birth weight (OR 1.56; 95% CI: 1.28–1.93), preterm birth (OR 1.49; 95% CI: 1.27–1.76), and small for gestational age (OR 1.48; 95% CI: 1.16–1.89). Despite variation in study designs and populations, the consistency of these associations reinforces the strength of the findings.
This analysis provides clear evidence that vaping during pregnancy is not without harm and should be considered a risk factor in clinical practice. The results underscore the importance of targeted public health messaging and enhanced clinical guidance to support smoking cessation that includes e-cigarettes. Limitations include high heterogeneity in some analyses and reliance on self-reported vaping behaviours, which may underestimate exposure. Nonetheless, these findings strongly suggest that vaping in pregnancy should not be considered a benign alternative to smoking and warrant further regulatory attention.
Reference
Deprato P et al. Associations between vaping during pregnancy and perinatal outcomes: A systematic review and meta-analysis. J Hazard Mater. 2025;DOI: 10.1016/j.jhazmat.2024.137028.
