Effects of Maternal E-Cigarette Use Around Pregnancy on Infants Born SGA

Amelia Makhanlall, Shannon Roy, Nisha Nair and Olabowale Olola

Box of cigarettes with Surgeon General's warning of potential pregnancy complications.

Cigarettes labeled with the Surgeon General's warning of potential pregnancy complications.

Graduate Student Project


Cigarettes are known to increase the risk of pre-term birth, low birth weight, and birth defects in developing infants. Do you believe that e-cigarettes have the same effects on birth outcomes that traditional cigarettes do?

We are current second-year Masters of Public Health students  at UB.  During our perinatal epidemiology class we had the opportunity to analyze data from the CDC regarding maternal behavior prior to and during pregnancy and associated infant health outcomes postpartum.  After the semester ended, we decided to expand our analysis, and looked into the association between maternal cigarette and e-cigarette use on risk of small for gestational age births.

Currently, there are no other studies looking at the effects of maternal e-cigarette use and risk for small for gestational births.  We have found literature regarding the topic, but they had small sample sizes and lacked smoking frequency data.  Our use of smoking frequency data tracks the dynamic changes of use throughout pregnancy and associated risk of SGA.   Through our analysis, we hope to address the rising concerns of maternal vaping use and birth outcomes.


We aimed to assess the effects of maternal e-cigarette use on small for gestational age (SGA) by analyzing the 2016-2017 phase of the Pregnancy Risk Assessment Monitoring Systems dataset (N=69,537 births). In 2-6 months postpartum, mothers reported their use of e-cigarettes and conventional cigarettes before, during, and after pregnancy. SGA was defined as birth weight below the 10th percentile by sex and gestational age.

The prevalence of e-cigarette use  was 3.7% before pregnancy and 1.2% during pregnancy. The prevalence of cigarette use was 19.0% before pregnancy and 9.2% during pregnancy. The prevalence of dual use was 2.8% before pregnancy and 0.8% during pregnancy. The risk of SGA was 14.9% in the total sample. Conventional cigarette use during pregnancy was associated with the highest risk of SGA, followed by e-cigarette use. Quitting use of both can almost normalize the risk of SGA.

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