Vaping During Pregnancy Could Be Associated With Increased Risk of Adverse Events

Vaping during pregnancy was associated with significantly increased risks of preterm birth, low infant birth weight (LBW), and small for gestational age (SGA) compared with pregnant patients not using nicotine. Researchers’ findings support complete cessation of nicotine use during pregnancy, according to findings from a study in Women and Birth.¹

“Vaping has become increasingly common among women of reproductive age, including those who are pregnant,” wrote the authors of the study. “Often marketed as a safer alternative to combustible tobacco products, vaping delivers nicotine through vaporized e-liquids rather than smoke. However, this method still exposes users to harmful substances such as nicotine, volatile organic compounds, heavy metals, and flavoring agents, all of which may adversely affect both maternal and fetal health.”

According to CDC statistics, vaping use through electronic cigarettes increased by 2% in the US population from 2019 to 2023. The age group most associated with vaping use was adults 21 to 24 years old, accounting for 15.5% of electronic cigarette users.² In 2011, the average age of a mother when she gave birth to her first child was 25.6 years old. Although this age increased to 27.3 years old in 2021, the prominence of vaping in these age groups has raised alarms for health care professionals working with expectant mothers.³

Although the impacts of vaping during pregnancy are still being explored in clinical settings, previous research findings have been significant regarding the potential risks that mothers who vape can pass down to their children. According to the authors of the current study, the toxicants in electronic cigarettes can impede placental development, reduce blood flow, and result in restricted fetal growth.¹

READ MORE: Inadequate Contraceptive Information Hinders Equity in Reproductive Care

With reports of up to 7% of women vaping during pregnancy, researchers wanted to bolster the current evidence of pregnancy outcomes among patients who vape because of inconsistent data and study designs.

“This systematic review and meta-analysis aims to clarify the association between maternal vaping and preterm birth, LBW, and SGA, compared with nonsmokers, tobacco smokers, and dual users,” they wrote.¹

The researchers explored various databases for studies on vaping during pregnancy spanning 1986 to 2024. Vaping did not become prominent in the US until at least 2006—when e-cigarettes were first imported into the country—but the analysis went back to 1986 to include further evidence regarding nicotine use and pregnancy outcomes.^1,4

Studies were only included in the researchers’ analysis if they explored populations with some exposure to vaping and then compared them with a group of patients comprising nonsmokers, users of tobacco only, and users of both electronic cigarettes and tobacco.

Of the vaping and tobacco use studies explored, the researchers included only those that reported on the following pregnancy outcomes: preterm birth (delivery of a newborn before 37 weeks of gestation), LBW (under 5.51 lb), and SGA (below the 10th percentile for gestational age and sex). These 3 outcomes were also determined as the primary outcomes for the researchers’ analysis.

Nine studies, consisting of 423,680 pregnant women, were included in the final analysis. Of the study population, 3170 exclusively vaped, 46,670 were tobacco smokers, 5454 used both, and 368,386 were considered nonsmokers.

Across the 3 pregnancy outcomes explored in the analysis, researchers found that vaping during pregnancy was associated with increased risks for all of them. Indeed, vaping was associated with a 40% increased risk of preterm birth, a 49% increased risk of LBW, and a 32% increased risk of SGA.

“This meta-analysis provides evidence that vaping during pregnancy is associated with increased risks of SGA, preterm birth, and LBW, compared with nonsmokers,” said the authors.¹ “Although the relative risk is lower than that observed among exclusive tobacco smokers or dual users, these findings strongly suggest that vaping is not a safe alternative to smoking during pregnancy.”

From previous evidence uncovered in various trials up to the current meta-analysis, researchers have reported on a significant number of instances that support the increased risks associated with vaping during pregnancy. However, as vaping use continues to grow, they believe that instances of adverse pregnancy outcomes will also increase. Despite pregnancy guidelines and recommendations almost always suggesting the cessation of nicotine for expectant mothers, there are still calls for a more concerted public health effort to address vaping during pregnancy.

“Health care providers must communicate the risks of vaping use and advocate for the complete cessation of nicotine during pregnancy,” concluded the authors. “Public health efforts must prioritize regulating vaping marketing to pregnant women and supporting non-nicotine–based cessation programs.”

READ MORE: Women’s Health Resource Center

Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.

REFERENCES

1. Vallée A, Eid M, Feki A, et al. Maternal vaping and pregnancy adverse outcomes: a systematic review and meta-analysis. Women and Birth. 2025;38(5):101951. doi:10.1016/j.wombi.2025.101951

2. Osterman AV, Briones E, Jamal A, et al. Electronic cigarette use among adults in the United States, 2019-2023. CDC. January 30, 2025. doi:10.15620/cdc/174583

3. Schaeffer K, Aragão C. Key facts about moms in the U.S. Pew Research Center. May 9, 2023. Accessed September 25, 2025. https://www.pewresearch.org/short-reads/2023/05/09/facts-about-u-s-mothers/

4. Historical timeline of vaping & electronic cigarettes. Consumer Advocates for Smoke-free Alternatives Association. Accessed September 25, 2025. https://casaa.org/education/vaping/historical-timeline-of-electronic-cigarettes/