Vaping during pregnancy (fetal developmental effects)
Of no less importance is fetal exposure to nicotine during pregnancy. Vaping prevalence in pregnant women has been estimated to stand between 0.6% and 15%104. Nicotine can cross the placenta and measurable nicotine levels can been detected in offspring of mothers smoking during pregnancy105. In uterus nicotine exposure increases the risk for eclampsia, premature birth, cleft lip and palate, reduced birth weight106–108, sudden infant death syndrome, altered corpus callosum, auditory defects, besides being related to future compromised fertility, type 2 diabetes, obesity, hypertension and respiratory dysfunction109,110. Nicotinic acetylcholine receptors regulate critical stages of brain development and nicotine neurotoxic effects on the developing brain have been widely demonstrated, including future hyperactivity, cognitive impairment, anxiety, mood and attention symptoms, sensitivity to stimulant drugs109,111–115. To date, e-cigarette impact on pregnant women and fetuses remains uncertain and further research should be established. A vast amount of studies carried out on animal models suggest pre- and postnatal alterations related with the exposure to both, nicotine and nicotine-free aerosols, including the down-regulation of genes implied in lung development116, an inverse relationship between plasma and urine cotinine level and body weight117, in addition to neuro-behavioural and developmental disorders similar to those resulting from conventional cigarette exposure118.