National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
Usher Institute, University of Edinburgh, Edinburgh, UK.
Nicotine Tob Res. 2021 Aug 18;23(9):1451-1458. doi: 10.1093/ntr/ntab017.
Smoking in pregnancy increases the risk of negative health outcomes. Vaping can be effective for smoking cessation in nonpregnant populations. We conducted a systematic review of vaping in pregnancy, covering prevalence, patterns of use, reasons for use, smoking cessation, and health effects.
Five academic databases were searched on 17 February 2020. Studies reporting prevalence, patterns, reasons, cessation, or health effects of vaping in pregnancy were included; animal and in vitro studies were excluded. A narrative review was used, with risk of bias assessed using Hoy and colleague's tool, the Newcastle-Ottawa scale, and the Consolidated Criteria for reporting Qualitative Research.
Twenty-three studies were identified: 11 survey, 7 qualitative, 3 cohort, and 2 secondary analyses of randomized clinical trials. Prevalence of vaping in pregnancy (four studies) was between 1.2% and 7.0% overall, and <1% among nonsmokers. Twelve studies reported patterns of use, but findings were inconsistent. Twelve of 14 studies asking why pregnant women vaped reported that most vaped to reduce or quit smoking. Mixed findings were reported from six studies on smoking cessation. Of three studies with health-related outcomes, two were underpowered and one reported similar birthweights for babies born to nonsmokers and women who vaped, with both higher (p < .0001) than the birthweight of babies born to smokers.
There were insufficient data to draw conclusions about prevalence, patterns, and effects of vaping in pregnancy on smoking cessation. The limited literature suggests that vaping in pregnancy has little or no effect on birthweight.
Smoking causes many negative health outcomes for pregnant women and to babies born to people who smoke. There remains a paucity of research on the effects of vaping in pregnancy. There is, however, the potential for vaping products to reduce the negative health outcomes associated with smoking. More research is needed to develop an evidence base in this area.
孕期吸烟会增加不良健康后果的风险。在非孕妇人群中，电子烟可能对戒烟有效。我们系统地综述了孕期电子烟使用的相关文献，涵盖了其在孕期的流行程度、使用模式、使用原因、戒烟效果以及健康影响。
我们于 2020 年 2 月 17 日在五个学术数据库中进行了检索。纳入了报告孕期电子烟使用的流行程度、模式、原因、戒烟效果和健康影响的研究；排除了动物和体外研究。我们采用叙述性综述方法，使用 Hoy 及其同事的工具、纽卡斯尔-渥太华量表和定性研究报告的综合标准来评估偏倚风险。
我们确定了 23 项研究：11 项调查、7 项定性研究、3 项队列研究和 2 项随机临床试验的二次分析。四项研究报告了孕期电子烟使用的流行程度，总体上介于 1.2%至 7.0%之间，非吸烟者中则低于 1%。12 项研究报告了使用模式，但结果不一致。在 14 项询问孕妇为何使用电子烟的研究中，有 12 项研究报告称，大多数孕妇使用电子烟是为了减少或戒烟。六项关于戒烟效果的研究报告结果喜忧参半。三项研究报告了与健康相关的结果，其中两项研究的效力不足，一项研究报告称，非吸烟者和电子烟使用者所生婴儿的出生体重相似，均高于吸烟者所生婴儿的出生体重（p <.0001）。
关于孕期电子烟使用的流行程度、模式和对戒烟的影响，我们没有足够的数据得出结论。有限的文献表明，孕期电子烟使用对出生体重几乎没有或没有影响。
吸烟会给孕妇和吸烟人群所生婴儿带来许多不良健康后果。关于孕期电子烟使用的影响，研究仍然很少。然而，电子烟产品有可能减少与吸烟相关的不良健康后果。需要进一步的研究来为这一领域建立证据基础。
