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13 Developmental and Reproductive Effects
Pages 461-472

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From page 461...
... Although there is little evidence to draw on in response to that concern, there are a range of opinions regarding its impact, as summarized recently. A review examining perception and use of electronic cigarettes during pregnancy found that the most common perceptions of e-cigarette use during pregnancy were that they posed some risk to maternal and child health, but were safer than combustible tobacco cigarettes for both mother and baby and that they may be used as a tool for smoking cessation (McCubbin et al., 2017)
From page 462...
... CHARACTERIZATION OF DISEASE ENDPOINTS AND INTERMEDIATE OUTCOMES The potential for e-cigarettes to affect the course and outcome of pregnancy is plausible, given the range and magnitude of known effects of combustible tobacco cigarette smoking, which includes placental abruption, ectopic pregnancy, preterm birth, fetal growth restriction, stillbirth, infant mortality, sudden infant death syndrome (SIDS) , and orofacial clefts (HHS, 2014)
From page 463...
... An evaluation of the use of NRT versus placebo among pregnant combustible tobacco cigarette smokers resulted in more favorable birthweights for the NRT group despite similar cotinine levels (presumably reflecting similar levels of nicotine intake) in one study (Wisborg et al., 2000)
From page 464...
... . This is especially relevant to pregnancy because women are often motivated to take measures to improve the health of their pregnancy and may be more motivated to stop smoking combustible tobacco cigarettes than at other times of their life.
From page 465...
... , using zebrafish and human embryonic stem cells, found negative health effects on heart development from both combustible tobacco cigarette and e-cigarette exposure of similar nicotine levels, but that combustible tobacco cigarette smoke exposure was more toxic. STUDIES ON COMBUSTIBLE TOBACCO AND NICOTINE The scarcity of studies examining the impact of e-cigarettes on fetal and postnatal development and reproductive health during pregnancy presents a significant limitation in predicting health effects of e-cigarette emissions on the fetus and pregnant mother.
From page 466...
... found that among subjects who died of sudden intrauterine unexpected death syndrome or of SIDS, those whose mothers smoked combustible tobacco cigarettes during pregnancy were more likely to have greater α7 nACHR immunostaining in lung epithelial cells and lung vessel walls compared with those whose mothers did not smoke combustible tobacco cigarettes. In a study examining the risk of major congenital abnormalities in children of mothers who smoked combustible tobacco cigarettes or used NRT, there were no differences between the two groups with the exception (OR = 4.65; 99% CI = 1.76–12.25)
From page 467...
... . Other studies have shown that prenatal nicotine exposure can stimulate lung branching through α7 nicotinic receptors in murine lung explants, possibly contributing to dysanaptic lung growth (­ ongtrakool W et al., 2007)
From page 468...
... Further studies are needed before recommendations can be made regarding the risks of e-cigarette use during pregnancy to fetal development and if e-cigarette use as a substitute for combustible tobacco cigarette smoking is a safer alternative compared with NRT. SYNTHESIS Given the lack of direct empirical evidence of e-cigarettes' effects on the mother or fetus, from either human or animal studies, little can be said regarding an integrated evaluation.
From page 469...
... 2016. Perceptions of emerging tobacco products and nicotine replacement therapy among pregnant women and women planning a pregnancy.
From page 470...
... 1999. Prenatal nicotine increases pulmonary α7 nicotinic receptor ex pression and alters fetal lung development in monkeys.
From page 471...
... 2012. Prenatal nicotine exposure alters lung function and airway geometry through α7 nicotinic receptors.


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