Margeaux W. Marbrey. PhD and her colleagues have recently published important studies in a murine model that provide additional reasons that electronic cigarette use in pregnancy is potentially harmful. Electronic cigarettes provide a base liquid of nicotine and flavoring that is supposed to be a safe alternative to smoking traditional cigarettes containing tobacco. It is reported that 15% pregnant women in the USA and UK use e-cigarettes. The are study conducted by the Marbrey Lab demonstrates that this assumption is not valid. The Duke scientists studied adult pregnant C57BL/6J mice exposed to flavored e-cigarettes with and without nicotine. SHAM controls were also studied. Flavored -cigarettes without nicotine caused erythrocyte accumulation at implantation site and the downregulation of placental development genes. This gene regulation varies depending on fetal sex. Later in gestation fetal reabsorption was noted in the pregnant mice. While the authors state that further studies are indicated, their work suggests that during human pregnancy the use of e-cigarettes would lead to fetal growth retardation and complications of placental development (1). Marbrey has published a number of studies on the effects of electronic cigarettes on pregnancy outcomes beginning with a 2019 paper showing that e-cigarette exposure delays implantation and causes reduced weight gain in female offspring (2).
Many followers of the Campion Fund will recall that at our 2019 meeting in Salt Lake City on Air Pollution Harms Reproductive Health, Judith T. Zelikoff presented a paper describing how prenatal exposure to e-cigarettes produced neuroinflammatory and behavior modifications in adult offspring. This was one of the first time that many in the reproductive health scientific community became aware of the harm of electronic cigarettes use in the prenatal period. At that meeting Dr. Zelikoff stated that the aerosolized base liquid containing nicotine and flavoring was a form of air pollution. The study she presented at the meeting was published in 2020 (3).
It is highly recommended that all clinicians educate their patients and clients about the harms of the use of prenatal electronic cigarettes.
Further suggested reading
(1) Marbrey, M. W., Cripps, S. M., Huang, R., Kistner, B. M., Somany, A., Douglas, E. S., & Caron, K. M. (2025). Flavored e-cigarettes modulate embryo development, fetal growth, and potentiate early fetal demise without nicotine. Communications Medicine, 5(1), 373.
(2) Wetendorf M, Randall LT, Lemma MT, Hurr SH, Pawlak JB, Tarran R, Doerschuk CM, Caron KM. E-Cigarette exposure delays implantation and causes reduced weight gain in female offspring exposed in utero. Journal of the Endocrine Society. 2019 3 (10) 1907: 1016.
(3) Church J S, Chace-Donahue F, Blum JL, Ratner JA, Zelikoff JT, Schwartzer JJ. Neuroinflammatory and behavioral outcomes measured in adult offspring of mice exposed prenatally to e-cigarette aerosols. Environmental Health Perspectives, 2020: 128( 4), 047006.