Tobacco smoking and vaping in pregnancy and neonatal outcomes: results from a UK cohort study
Abstract
Abstract Background Although the harms of smoking during pregnancy are well established, there is less evidence on the impacts of vaping. Methods We analysed data on caregiver-reported birthweight, low birthweight (LBW, <2.5kg), postnatal hospital stay, and admission to a neonatal care unit from interviews for 1,896 babies in the UK Early Life Cohort Feasibility Study (9–10 months sweep). Smoking and vaping during pregnancy were classified as “yes” vs “never” to form four mutually exclusive exposure groups. Models adjusted for sociodemographic factors and survey weights. Linear, logistic, and negative binomial regressions were used. Sensitivity analyses included exposure frequency categories and models using logged birthweight or household income. Findings Most mothers (90.1%, N=1528) neither smoked nor vaped; 2.6% (N=44) vaped only, 5.5% (N=93) smoked only, and 1.8% (N=31) were dual users. Mean birthweights were 3.31 kg where mothers neither smoked nor vaped and 3.00kg where mothers smoked but did not vape. Compared to unexposed mothers, adjusted models showed lower birthweight for babies of mothers who smoked (-0.34kg, p<0.001) and where mothers were dual users (-0.39kg, p=0.001).Smoking exposure demonstrated a dose-response association with lower birthweight (trend p=0.001) and LBW (p<0.001), while vaping showed no associations. Dual use was associated with longer hospital stay (+0.88 days; p=0.001); smoking or vaping alone were not. No group differed in the incidence of…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,528 participants or records.
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