Zhang Yijia, Angley Meghan, Qi Xinran, Lu Liping, D'Alton Mary E, Kahe Ka
Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY (XX Zhang, XX Angley, XX Lu, XX D'Alton, and XX Kahe); Department of Epidemiology, Columbia University Irving Medical Center, New York, NY (XX Zhang, XX Angley, XX Lu, and XX Kahe).
School of Nursing, Capital Medical University, Beijing, China (XX Qi).
Am J Obstet Gynecol MFM. 2022 Sep;4(5):100659. doi: 10.1016/j.ajogmf.2022.100659. Epub 2022 May 11.
Electronic cigarettes (e-cigarettes) have become increasingly popular in young generations in the United States. Because the adverse pregnancy outcomes associated with combustible cigarette smoking are well-recognized, many pregnant women switch to e-cigarettes believing that this alternative is low in toxic chemicals. However, most e-cigarettes contain nicotine, which can easily pass through the placenta and accumulate to a high concentration in fetal blood circulation. Studies have also detected toxic metals (eg, lead, cadmium, and nickel) in e-cigarettes, and carbonyl compounds and flavorings, which are suggested to be irritative and even carcinogenic. There are questions that need to be answered about the risks of e-cigarette exposure during pregnancy. Unfortunately, research evaluating the association between maternal e-cigarette exposure and offspring health is scarce, especially with regard to human studies. Some evidence from laboratory and animal studies, although inconsistent, showed that maternal exposure to e-cigarette vapor may lead to restricted growth of offspring. E-cigarette exposure may also have an impact on the metabolic health of offspring, manifested as distorted glucose homeostasis and energy metabolism. In addition, in utero exposure may lead to defects in respiratory, vascular, and neurologic system development. For humans, investigations mostly focused on immediate birth outcomes such as small-for-gestational-age neonates, low birthweight, and preterm birth; however, the results were inconclusive. Research also suggests that maternal e-cigarette exposure may result in compromised neurodevelopment in newborns. In summary, current evidence is insufficient to rigorously evaluate the health impacts of maternal e-cigarette use on offspring development. Future investigations are warranted.
电子烟在美国年轻一代中越来越受欢迎。由于与吸传统香烟相关的不良妊娠结局已得到充分认识，许多孕妇转而使用电子烟，认为这种替代品的有毒化学物质含量较低。然而，大多数电子烟都含有尼古丁，尼古丁很容易穿过胎盘并在胎儿血液循环中积聚到高浓度。研究还在电子烟中检测到有毒金属（如铅、镉和镍）以及羰基化合物和调味剂，这些物质被认为具有刺激性甚至致癌性。关于孕期接触电子烟的风险，仍有一些问题需要解答。不幸的是，评估孕妇接触电子烟与后代健康之间关联的研究很少，尤其是人体研究。来自实验室和动物研究的一些证据虽然并不一致，但表明孕妇接触电子烟烟雾可能会导致后代生长受限。接触电子烟还可能对后代的代谢健康产生影响，表现为葡萄糖稳态和能量代谢紊乱。此外，子宫内接触电子烟可能会导致呼吸、血管和神经系统发育缺陷。对于人类而言，研究大多集中在诸如小于胎龄儿、低出生体重和早产等即时出生结局上；然而，结果尚无定论。研究还表明，孕妇接触电子烟可能会导致新生儿神经发育受损。总之，目前的证据不足以严格评估孕妇使用电子烟对后代发育的健康影响。未来有必要进行进一步的调查。
