# Adverse Physical Consequences of Perinatal E-cigarette Use by Pregnant Mothers on Their Offspring: A Scoping Review

## TL;DR

This review explores how e-cigarette use during pregnancy can harm children's facial and lung development, based on studies in humans and animals.

## Contribution

The study systematically reviews perinatal e-cigarette effects on offspring, highlighting nicotine's role and suggesting future research on metabolite thresholds.

## Key findings

- Nicotine from e-cigarettes crosses the placenta and is measurable as cotinine in the fetus.
- Animal studies show nicotine exposure can alter jaw and facial development in offspring.
- Perinatal e-cigarette exposure is linked to craniofacial and pulmonary issues and increased stillbirth risk.

## Abstract

E-cigarette use among pregnant women has increased as a smoking cessation method, raising public health concerns about fetal chemical exposure, yet most research relies on animal models rather than human studies. This scoping review assessed literature on perinatal e-cigarette use by pregnant mothers and its physiological and morphological consequences for children aged 0-3 years by systematically reviewing peer-reviewed publications from January 2013 to December 2023 using EMBASE, Ovid MEDLINE, and Web of Science databases, ultimately including eight studies after applying the Joanna Briggs Institute tools from an initial 32 studies meeting inclusion criteria. Results demonstrated that nicotine crosses the placental barrier, allowing measurement of its primary metabolite, cotinine, in the fetus. Studies in fetal mice indicate that nicotine exposure during development may lead to alterations in jaw and facial morphology. The evidence indicates that perinatal e-cigarette exposure negatively impacts newborn craniofacial and pulmonary development and can result in stillbirth and life-threatening consequences in both human and animal subjects, suggesting future research should expand fetal measurements to include accurate levels of active nicotine metabolites like cotinine to provide physicians insight into substance thresholds that produce specific abnormalities.