(183) The Impact of E-cigarettes on Pregnancy & Childhood Health Outcomes - The ECHO Study

E-cigarette use is increasingly prevalent in pregnancy, yet maternal and infant outcomes remain poorly understood with few longitudinal studies examining outcomes. The ECHO Study (The impact of E-Cigarettes on pregnancy and Childhood Health Outcomes – NCT: 06297005) - is a prospective, multicentre, observational cohort study of women and fetuses exposed to E-cigarettes (1).  

Study Design:

Three groups of pregnant women were recruited; smokers, e-cigarette users and non-users. Their exposure status was objectively determined using specific biomarkers (exhaled breath carbon monoxide and urine cotinine analysis). Obstetric outcomes examined included birthweight, small for gestational age and gestation at delivery.

Results:

Outcomes for 684 women are presented with 307 controls, 200 smokers, 143 vapers and 34 vaper/smokers. Chi-squared tests were used for comparison of proportions, and Wilcoxan rank-sum tests were used for non-parametric data. Demographic and obstetric outcomes are described in Tables 1 and 2.

Vaping mothers had infants of similar birthweight to controls (p-value 0.8) and their babies were significantly heavier than those of smoking mothers (p=0.05). Smokers had significantly more babies < 10^th percentile for gestational age than vapers (p-value < 0.0001). No significant difference in median gestational age , rate of preterm birth or admission to NICU was found (Table 2).  

Conclusion:

 Unlike cigarette smoking, E-cigarette usage in pregnancy is not associated with an increase in SGA babies. This is a clinically relevant finding and contrasts with earlier studies which interpret large datasets. The strength of our study lies in its prospective design and use of objective biomarker determination of exposure groups providing reliable confirmation of cigarette consumption and E-cigarette usage.

Refs.

1. Healy EF, O’Connell A, Yousef MS, Reddin A, Boyle M, Coleman T, et al. The impact of electronic cigarettes on pregnancy and childhood health outcomes: the ECHO study—a protocol for a multicentre, prospective, observational, cohort. Archives of Gynecology and Obstetrics. 2025:1-9.