Adverse Maternal and Infant Outcomes of Women Who Differ in Smoking Status: E-Cigarette and Tobacco Cigarette Users

Eline K Nanninga; Stella Weiland; Marjolein Y Berger; Esther I Feijen-de Jong; Jan Jaap H M Erwich; Lilian L Peters

doi:10.3390/ijerph20032632

Adverse Maternal and Infant Outcomes of Women Who Differ in Smoking Status: E-Cigarette and Tobacco Cigarette Users

Int J Environ Res Public Health. 2023 Feb 1;20(3):2632. doi: 10.3390/ijerph20032632.

Authors

Eline K Nanninga¹, Stella Weiland^{1

2

3

4}, Marjolein Y Berger³, Esther I Feijen-de Jong^{1

2

3

4}, Jan Jaap H M Erwich⁵, Lilian L Peters^{1

2

3

4}

Affiliations

¹ Amsterdam UMC, Location Vrije Universiteit Amsterdam, Midwifery Science, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
² Midwifery Academy Amsterdam Groningen, InHolland, Dirk Huizingastraat 3-5, 9713 GL Groningen, The Netherlands.
³ Department of General Practice & Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
⁴ Amsterdam Reproduction and Development, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
⁵ Department of Obstetrics & Gynecology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.

Abstract

The electronic cigarette (e-cigarette) became commercially available around 2004, yet the characteristics of pregnant women who use these devices and their effects on maternal and infant health remain largely unknown. This study aimed to investigate maternal characteristics and pregnancy outcomes according to maternal smoking status. We conducted a cross-sectional study of Dutch women with reported pregnancies between February 2019 and May 2022, using an online questionnaire to collect data on smoking status and demographic, lifestyle, pregnancy, and infant characteristics. Smoking status is compared among non-smokers, tobacco cigarette users, e-cigarette users, and dual users (tobacco and e-cigarette). We report descriptive statistics and calculate differences in smoking status between women with the chi-square or Fisher (Freeman-Halton) test. Of the 1937 included women, 88.1% were non-smokers, 10.8% were tobacco cigarette users, 0.5% were e-cigarette users, and 0.6% were dual users. Compared with tobacco users, e-cigarette users more often reported higher education, having a partner, primiparity, and miscarriages. Notably, women who used e-cigarettes more often had small infants for gestational age. Despite including few women in the e-cigarette subgroup, these exploratory results indicate the need for more research to examine the impact of e-cigarettes on pregnancy outcomes.

Keywords: derivatives; electronic cigarettes; health consequences; nicotine; prenatal exposure.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Electronic Nicotine Delivery Systems*
Female
Humans
Infant
Nicotiana
Pregnancy
Smoking / adverse effects
Smoking / epidemiology
Tobacco Products*
Vaping*

Grants and funding

This work was supported by the Dutch institute ZonMW (grant number 531 003018) as part of the broader project “Together we’ll quit smoking!” “Optimizing the implementation of the Trimbos guideline “smoking cessation counseling” in the daily practice of healthcare professionals supporting low-SES pregnant women in the North or the Netherlands.” ZonMW had no involvement in the study design or the collection, analysis, or interpretation of the data.