Vaping during pregnancy and maternal, fetal, and infant health outcomes: A scoping review of human and animal studies
4 affiliations
- 1Maternal and Fetal Health Research Centre 5th floor (Research), Saint Mary’s Hospital, Manchester, United Kingdom
- 2Manchester University NHS Foundation Trust, Obstetrics, Manchester, England, United Kingdom
- 3Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, England, United Kingdom
- 4Institute of Social Marketing and Health, University of Stirling, Stirling, United Kingdom
Abstract
Background: The prevalence of vaping, defined as the use of e-cigarettes, during pregnancy is increasing, but its effects on maternal, fetal, and infant health remain incompletely understood. Human studies are heterogeneous and largely observational with a primary focus on neonatal and infant outcomes and limited assessment of maternal physiology. In contrast, pre-clinical animal studies suggest potential biological effects across maternal vascular, respiratory, metabolic, and neurodevelopmental systems. A comprehensive mapping of the existing evidence is therefore needed to characterise the scope of research to date and identify key gaps in the literature. Objective: To map the extent, range, and nature of human and animal studies examining the effects of vaping during pregnancy on maternal, fetal, and infant health outcomes, and to describe key methodological features and gaps to inform future research. Materials and methods: A scoping review was conducted following Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Electronic database searches for human and animal studies examining the effects of vaping during pregnancy were conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, PsycInfo, and grey literature, which were completed September 10th, 2025. Data were extracted on study design, population, exposure definitions, outcome domains, and use of biochemical exposure validation. No formal risk-of-bias assessment was undertaken, consistent with scoping review methodology, instead study characteristics were mapped descriptively. Results: 64 studies were included (34 animal, 30 human). Human studies were predominantly observational and varied in design. Most relied on retrospective self-report without biochemical validation, potentially contributing to contradictory findings. Outcomes were focused mainly on perinatal measures, with maternal outcomes limited to breastfeeding, postpartum depression, and gestational weight gain, and little or no assessment of maternal physiological outcomes such as vascular or autonomic function. In contrast, animal studies frequently investigated mechanistic outcomes, suggesting potential biological effects across multiple systems including metabolic, respiratory, neurobehavioural, and cardiovascular impairment, with greater severity in nicotine-exposed groups. However, exposure paradigms and species differences limit direct translation to human pregnancy. Conclusion: The existing evidence base on vaping in pregnancy is characterised by substantial heterogeneity and notable gaps. In particular, there is a lack of prospective human studies incorporating objective exposure assessment and mechanistic maternal outcomes. Comparative analyses frequently evaluated vaping relative to combustible cigarette smoking. However, substantial variability in exposure classification, comparator groups, and adjustment for confounding limits interpretability. Animal studies more thoroughly examine mechanistic pathways and multiple organ systems. However physiological differences and unrealistic exposure models limit generalisability to human pregnancy. Overall, the current literature is insufficient to draw firm conclusions regarding risk. These findings highlight priorities for future research to strengthen the evidence base and improve understanding of the biological effects of vaping during pregnancy.
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BibTeX
@article{fielder2026vaping,
title = {{Vaping during pregnancy and maternal, fetal, and infant health outcomes: A scoping review of human and animal studies}},
author = {Stella Fielder and Chloe Barnes and Laura Ormesher and Sarah Arrowsmith and Rehan Junejo and Michael Ussher and Alexander Heazell},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0356305},
url = {https://doi.org/10.1371/journal.pone.0356305},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Vaping during pregnancy and maternal, fetal, and infant health outcomes: A scoping review of human and animal studies
AU - Stella Fielder
AU - Chloe Barnes
AU - Laura Ormesher
AU - Sarah Arrowsmith
AU - Rehan Junejo
AU - Michael Ussher
AU - Alexander Heazell
PY - 2026
DA - 2026/09/29
JO - PLOS One
DO - 10.1371/journal.pone.0356305
UR - https://doi.org/10.1371/journal.pone.0356305
AB - Background: The prevalence of vaping, defined as the use of e-cigarettes, during pregnancy is increasing, but its effects on maternal, fetal, and infant health remain incompletely understood. Human studies are heterogeneous and largely observational with a primary focus on neonatal and infant outcomes and limited assessment of maternal physiology. In contrast, pre-clinical animal studies suggest potential biological effects across maternal vascular, respiratory, metabolic, and neurodevelopmental systems. A comprehensive mapping of the existing evidence is therefore needed to characterise the scope of research to date and identify key gaps in the literature. Objective: To map the extent, range, and nature of human and animal studies examining the effects of vaping during pregnancy on maternal, fetal, and infant health outcomes, and to describe key methodological features and gaps to inform future research. Materials and methods: A scoping review was conducted following Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Electronic database searches for human and animal studies examining the effects of vaping during pregnancy were conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, PsycInfo, and grey literature, which were completed September 10th, 2025. Data were extracted on study design, population, exposure definitions, outcome domains, and use of biochemical exposure validation. No formal risk-of-bias assessment was undertaken, consistent with scoping review methodology, instead study characteristics were mapped descriptively. Results: 64 studies were included (34 animal, 30 human). Human studies were predominantly observational and varied in design. Most relied on retrospective self-report without biochemical validation, potentially contributing to contradictory findings. Outcomes were focused mainly on perinatal measures, with maternal outcomes limited to breastfeeding, postpartum depression, and gestational weight gain, and little or no assessment of maternal physiological outcomes such as vascular or autonomic function. In contrast, animal studies frequently investigated mechanistic outcomes, suggesting potential biological effects across multiple systems including metabolic, respiratory, neurobehavioural, and cardiovascular impairment, with greater severity in nicotine-exposed groups. However, exposure paradigms and species differences limit direct translation to human pregnancy. Conclusion: The existing evidence base on vaping in pregnancy is characterised by substantial heterogeneity and notable gaps. In particular, there is a lack of prospective human studies incorporating objective exposure assessment and mechanistic maternal outcomes. Comparative analyses frequently evaluated vaping relative to combustible cigarette smoking. However, substantial variability in exposure classification, comparator groups, and adjustment for confounding limits interpretability. Animal studies more thoroughly examine mechanistic pathways and multiple organ systems. However physiological differences and unrealistic exposure models limit generalisability to human pregnancy. Overall, the current literature is insufficient to draw firm conclusions regarding risk. These findings highlight priorities for future research to strengthen the evidence base and improve understanding of the biological effects of vaping during pregnancy.
SN - 1932-6203
ER -