Evidence map›Paper›PMID 41316218›Full record

SynthesisBMC public health2025

Comparative effects of electronic cigarettes and dual use of electronic and conventional cigarettes on adverse pregnancy outcomes: a systematic review and meta-analysis.

Kanokporn Sukhato, Thunyarat Anothaisintawee, Natasha Chawla, Suparee Boonmanunt, Amarit Tansawet, Prapaporn Pornsuriyasak, Patcharanat Inpithuk, Gareth J McKay, John Attia, Ammarin Thakkinstian

Abstract readComparative StudyNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Kanokporn SukhatoDepartment of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Thunyarat AnothaisintaweeDepartment of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Thunyarat.ano@mahidol.ac.th.
Natasha ChawlaDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Suparee BoonmanuntDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Amarit TansawetDepartment of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Prapaporn PornsuriyasakDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Patcharanat InpithukDepartment of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Gareth J McKayCentre for Public Health, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK.
John AttiaCentre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, Australia.
Ammarin ThakkinstianDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis systematic review and meta-analysis aimed to evaluate the effects of electronic cigarette (E-cigarette) use and dual-use of E-cigarettes and conventional cigarettes (C-cigarettes) during pregnancy on adverse pregnancy outcomes, compared to C-cigarette use and non-use.

methodsA two-step search was conducted: first, systematic reviews (SRs) on the effects of E-cigarette use during pregnancy were identified from Medline and Scopus up to November 7, 2023; second, an updated search from the last search of previous SRs to May 30, 2025, was performed to capture additional relevant studies. Eligible studies included observational studies and randomized controlled trials (RCTs) that assessed the impact of E-cigarette or dual-use on adverse pregnancy outcomes, with non-use or C-cigarette use as comparators. A two-stage network meta-analysis was conducted to compare the effects of E-cigarette use, dual-use, and non-use.

resultsTwelve studies (eleven observational and one RCT) were included. E-cigarette use was significantly associated with an increased risk of preterm birth (odds ratio = 1.67; 95% confidence interval [CI]: 1.11 to 2.51) and lower mean birth weight (mean difference = -57 g; 95% CI: -105 to -9) compared to non-use. However, the risks of small for gestational age (SGA), miscarriage, and mean gestational age at delivery in E-cigarette users did not differ from those in non-users. Dual use of E-cigarettes and C-cigarettes was significantly associated with increased risks of SGA, preterm birth, and lower mean birth weight compared to non-use. Compared to C-cigarette use, E-cigarette use was associated with lower risks of SGA and higher mean birth weight, while risks of preterm birth, miscarriage, and mean gestational age at delivery, did not differ between E-cigarette and C-cigarette users.

conclusionE-cigarette use during pregnancy was significantly associated with an increased risk of preterm birth and lower mean birth weight compared to non-use. Additionally dual-use was associated with elevated risks of SGA, preterm birth, and lower mean birth weight, compared to non-use. Although E-cigarette use was significantly associated with higher mean birth weight and decreased risk of SGA compared with C-cigarettes, no significant association was observed for other outcomes. These findings may be influenced by residual confounding and further high-quality studies are warranted to clarify the effect of E-cigarette use during pregnancy.

trial registrationThe review protocol has been registered at the PROSPERO website since 19 March 2024 (CRD42024521271).

Indexed as

Electronic Nicotine Delivery SystemsPregnancy OutcomeTobacco ProductsVapingFemaleHumansPregnancyPremature BirthAdverse pregnancy outcomesConventional cigaretteElectronic cigaretteMeta-analysisPregnancySystematic review

Identifiers

PMID41316218
PMCPMC12752007

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.