A recent cohort study delving into the prevalence and impact of e-cigarette and cigarette use among pregnant adolescents in the United States has unearthed significant trends and potential implications for birth outcomes. Examining data from 2016 to 2021, the study, based on the Pregnancy Risk Assessment Monitoring System, scrutinised the habits and subsequent risks associated with these tobacco products.

This study was published in JAMA Network Open by Xiaozhong Wen and colleagues.The study encompassed a cohort of 10,428 pregnant adolescents between the ages of 10 to 19 years, each having comprehensive data available regarding their usage of e-cigarettes or cigarettes, along with the occurrences of small-for-gestational-age (SGA) births. The exposure under scrutiny centred on the self-reported use of e-cigarettes and cigarettes by adolescents during the last trimester of their pregnancies.
Prevalence Shifts:
Exclusive E-cigarette Use: Increased from 0.8% in 2016 to 4.1% in 2021.
Exclusive Cigarette Use: Decreased from 9.2% in 2017 to 3.2% in 2021.
Dual Use: Fluctuated between 0.6% and 1.6%.
Sociodemographic Differences:
Ethnic Disparities: White pregnant adolescents had higher e-cigarette use rates compared to other racial groups.
Increasing Use: Particularly noticeable among adolescents of White ethnicity.

Association with SGA Birth:
E-cigarette Use: No significant increase in the risk of SGA birth.
Cigarette Use: Showed a more than 2-fold higher risk of SGA birth compared to non-users.
Dual Use: Also associated with a higher risk, but not statistically significant.
The study implies a notable surge in e-cigarette use among pregnant adolescents, particularly among those identifying as White. While cigarette use demonstrated a clear association with increased risk of SGA birth, e-cigarette use during late pregnancy did not show a statistically significant correlation. However, the uncertainty surrounding this non-significant association suggests the need for further comprehensive research with larger sample sizes.
Reference:
Wen, X., Liu, L., Moe, A. A., Ormond, I. K., Shuren, C. C., Scott, I. N., Ozga, J. E., Stanton, C. A., Ruybal, A. L., Hart, J. L., Goniewicz, M. L., Lee, D., & Vargees, C. Use of E-cigarettes and cigarettes during late pregnancy among adolescents. JAMA Network Open, 6(12), e2347407. https://doi.org/10.1001/jamanetworkopen.2023.47407