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RE
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PAPER
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Impac o ma e nal exposu e o e-ciga e e apo on o sp ing
heal h ou comes: A sys ema ic e iew o animal s udies
Za ina Ka e C.
Laggui
*
Cagayan S a e Uni e si y a Lal
-
lo
, Philippines
A icle published on July 16, 2023
Key wo ds:
Ma e nal e
-
ciga e e exposu e,
Vaping
,
O sp ing
heal h ou comes,
Animal
model
Abs ac
Since hei in oduc ion in 2007, elec onic ciga e es ha e gained popula i y, much o which come om he
no ion ha i is a sa e al e na i e o adi ional ciga e es, e en o women du ing p egnancy. These asse ions
a e based in la ge pa on he ac ha e-ciga e e apo s con ain less oxican compa ed wi h ciga e e smoke.
Li le is known ye abou he e ec s o p ena al exposu e on o sp ing; hence, his pape aims o p o ide an
o e iew o he cu en esea ch on he impac s o p ena al e-ciga e e exposu e o o sp ing heal h ou comes.
Since a clinical s udy in humans is sca ce, his e iew e e s only o animal s udies published om 2018 o
p esen . All ele an s udies we e sys ema ically selec ed om online da abases (Google Schola , Web o Science,
PubMed, NCBI, Resea ch Ga e, Science Di ec ). The sea ch yielded 10 signi ican esea ch pape s. Mos s udies
included made use o mu ine model o ma e nal e-ciga e e exposu e. P ena al exposu e o e-ciga e es o high
nico ine le els esul ed o educed bi h weigh and li e size. Ma e nal aping p oduced de elopmen al
dys unc ion in ca dio ascula , pulmona y, hepa ic and enal sys ems o o sp ing. Mo eo e , a lic ed o sp ing
had sho e m memo y de ici s, and impai ed lea ning and objec ecogni ion abili y. Hype ac i i y and
dec eased anxie y beha io a e also exhibi ed by p ena ally exposed o sp ing. I is also no ed ha e – ciga e e
apo con e s ad e se heal h ou comes, independen o nico ine con en . Based on hese indings, i is hen
ecommended ha a mo e in ense educa ion and awa eness p og am on he de imen al e ec s o e-ciga e e
smoking be gi en o p egnan women o child-bea ing age, as well as p ena al ca e p o essionals.
*
Co esponding Au ho : Za ina Ka e C. Laggui [email protected]
Jou nal o Biodi e si y and En i onmen al Sciences (JBES)
ISSN: 2220-6663 (P in ) 2222-3045 (Online)
Vol. 23, No. 1, p. 163-174, 2023
h p://www.innspub.ne
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In oduc ion
Ma e nal smoking du ing p egnancy emains one o
he mos impo an modi iable isk ac o s o poo
p egnancy ou comes (Li e al., 2020; Aboaziza e al.,
2023). Ma e nal smoking no only ad e sely impac s
ma e nal heal h bu also esul s in poo e al and
pos na al ou comes including bu no limi ed o
obacco-induced abo ions and s illbi hs, low bi h
weigh (LBW) (We endo e al., 2019; Wang e al.,
2020; A chie e al., 2023), sudden in an dea h
synd ome (SIDS), p e e m bi h, neu ological and
cogni i e delays (Nguyen e al., 2018; Bu age e al.,
2021; A chie e al., 2023), congeni al disabili ies,
colic, as hma and a opic p egnancies.
Elec onic ciga e e o e-ciga e e (e-cig), commonly
known as aping is a ba e y powe ed
elec onic nico ine deli e y sys ems (ENDS), which
has become ex emely popula among all age g oups
and sexes since i en e ed he US ma ke in 2007 (Li
e al., 2020; A chie e al., 2023). Elec onic ciga e es
(commonly called "e-ciga e es" o “ apes”) a e
p omo ed as a smoking cessa ion aid wi h claims o
sa e y o e adi ional ciga e es. Thei popula i y is
based on pe cep ions o sa e y, cu en ends, and
lowe p ices compa ed o adi ional ciga e e
smoking. E en among hose who ha e ne e smoked
obacco be o e, e-ciga e e aping has g own in
popula i y o e he pas en yea s. Su p isingly,
ecen s udies ha e epo ed ha e-ciga e e usage is
also popula in women o child-bea ing age and up o
15% o he p egnan women a e now using e-cigs
(A chie e al., 2023), a end encou aged by he
pe cep ion ha aping is sa e han smoking o
p egnan women. This may unin en ionally inc ease
he numbe o people exposed o e- apo in u e o
gi en he p e alence o unplanned bi hs and
pe cep ions owa d sa e y o e-ciga e e smoking
(Aboaziza e al., 2023). This is conce ning since li le
is known abou he o e all heal h consequences o
long- e m e-ciga e e usage, and e en less in he
con ex o p egnancy. E-ciga e es mainly con ain a
solu ion o nico ine along wi h se e al addi i es
including p opylene glycol, ege able glyce in,
ac olein, o maldehyde, a o ing agen s and o he
ace elemen s, some o which may be oxic o heal h
including de eloping e us and o sp ing. Al hough
long- e m oxic e ec s o p ena al obacco smoke
exposu e on pos na al heal h a e well-documen ed
and well es ablished, limi ed p eclinical and clinical
s udies exis o e alua e he impac o ma e nal
aping on neona al heal h ou comes.
As e-ciga e es a e a ela i ely new p oduc , he e a e
only ew esea ches conduc ed on how using hem
du ing p egnancy would a ec he unbo n child.
P e ious e iews emphasized he necessi y o human
esea ch o p o ide indings ha accu a ely e lec he
ou come o p ena al e-ciga e e use. The inc easing
numbe o ape s also shows ha a be e
unde s anding o he e ec s o e-ciga e es on human
e al and pos na al de elopmen is essen ial and
equi ed in o de o be e in o m p egnan women
and assess he isks o he a ec ed o sp ing. Hence,
his cu en pape p o ides a e iew o he e ec s o
ma e nal e-ciga e e apo exposu e on o sp ing
heal h ou comes based on animal models. This
p esen he cu en s a e o esea ch on he lack o
human clinical s udies.
Ma e ials and Me hods
Da a Sou ces and Li e a u e Sea ch S a egy
This e iew u ilized he P e e ed Repo ing I ems o
Sys ema ic Re iews and Me a-Analyses 2020
(PRISMA) as i s design and guideline in he selec ion
and e alua ion o published a icles, as well as in
epo ing o summa ized esul s.
The li e a u e sea ch on impac o ma e nal exposu e
o o sp ing heal h ou comes was conduc ed in
uni e sally ecognized sea ching online da abases,
namely Google Schola , Web o Science, PubMed and
Na ional Cen e o Bio echnology In o ma ion
(NCBI), Science Di ec , and Resea ch Ga e. These
me a-da abases we e chosen o hei b oad ange o
highly scien i ic publica ions.
App op ia e keywo ds and Boolean ope a o s, such as
“and” o “o ” we e used o a mo e e icien and
e ec i e sea ch o publica ions o high ele ance o
he opic o his e iew.
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The sea ch used a combina ion o he ollowing six
keywo d ca ego ies (A-F): [A] Ma e nal, mo he ,
p ena al, p egnancy, p egnan woman; [B] O sp ing,
neona es, neona al, e us, li e s, p ogeny; [C] impac ,
e ec , ou comes, consequence; [D] E-ciga e e, ape,
aping, ENDS, elec onic nico ine deli e y sys em, e-
apo , ae osol; [E] Heal h ou comes, bi h ou comes,
bi h pa ame e s, bi h de ec s, congeni al de ec s;
and [F] Animal s udies, animal models, a , mouse,
mice.
All ele an a icles included in his e iew mus belong
o he ollowing ca ego ies: [A] s udies which in ol es
exposu e o p egnan mo he s o e-ciga e e apo , and
no he e-liquid; [B] s udies whe e p ogeny a e a
pos na al s age, and no a emb yonic s age [C] s udies
wi h indings ela ed o he impac o ma e nal exposu e
o e-ciga e e apo on o sp ing; [D] s udies ha use
animal models and no human subjec s. Sea ch esul s
selec ion is es ic ed by yea o publica ion,
language, and s udy ca ego y. Only esea ch a icles
published om 2018 o p esen , and w i en o
ansla ed o English language a e conside ed.
Re iew a icles, case epo s, case se ies, and
na a i e e iews a e excluded, wi h ha o a icles
wi h no a ailable ull ex .
Following he li e a u e sea ch, and elimina ion o
duplica es, he i les and abs ac s o all pape s ound
we e ead i s . Final sc eening o esea ch a icles
based on eligibili y c i e ia came nex o sc een ou
i ele an pape s o he cu en opic. The ull ex s o
he emaining pape s we e hen e iewed.
Sea ch Resul s and Da a Ex ac ion
A o al o 62 a icles we e ini ially iden i ied and
downloaded om he combina ion o sea ch e ms
om he six online da abases. Ini ial sc eening
esul ed om exclusion o 28 s udies ha we e
published beyond he ange o speci ied yea o
publica ion (2018-2023), and/o a e w i en in non-
English language wi h no a ailable ansla ion.
Fig. 1. PRISMA 2020 low diag am o he s ages o s udy iden i ica ion and sc eening esul s.
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A e emo al o duplica ed (6) s udies, only 29 s udies
emained and subjec ed o u he sc eening based on
inclusion and o he exclusion c i e ia. Six een a icles
emained a e e alua ing he con en based on he
abs ac s. Remo ed a icles we e hose ha used human
coho s udies (7), whe e indings we e ha on he e ec
o aping on he p egnan mo he s and no on o sp ing
(2), in ol ed subjec s we e a emb yonic s age and no o
ull- e m o pos na al o sp ing (3), and whe e mode o
e-ciga e e exposu e is by e-liquid and no by e- apo o
ae osol (1). The las s age o sc eening inally esul ed o
10 eligible a icles o ull ex e iew. The six excluded
a icles we e ha o e iew a icles, na a i e e iews o
case s udies. The s ages o s udy selec ion and esul s a e
p esen ed in he PRISMA 2020 low diag am (Fig. 1).
This e iew includes a sys ema ic o e iew o he
impac o ma e nal exposu e o e-ciga e e apo o
o sp ing heal h ou comes. All he e ie ed
publica ions we e e alua ed, and da a pe inen o he
speci ic objec i es o he e iew was manually
eco ded in MS Wo d. The da a collec ed om each
s udy include: animal model used, s udy popula ion,
ac i e subs ance in e-ciga e e liquid, pe iod o
ma e nal exposu e o e-ciga e e apo , and heal h
ou comes o o sp ing. De ails o he s udy such as
name o he au ho /s and publica ion da e o a icle
a e also eco ded.
Resul s and discussions
Neu obiology, Cogni ion and Beha io
The ollowing sec ion desc ibes he e ec s o p ena al
e-ciga e e exposu e on neu obiology, cogni ion, and
beha io in a ec ed o sp ing. O he 10 esea ch
a icles e iewed, only h ee s udies p o ided
in o ma ion on his, which is lis ed on Table 1.
Table 1. Animal s udies on ma e nal e-ciga e e apo exposu e and i s neu obiological, cogni i e and beha io al
e ec s on o sp ing.
Au ho and
Yea o
Publica ion
Animal
Model
Used
S udy
Popula ion
Ac i e
Subs ance
Pe iod o
Exposu e
Findings
Bu age
e
al., 2021
[3]
Sp ague
Dawley
Ra s
15 mo he s
E-liquid wi h
and wi hou
nico ine
(18mg/mL) +
F ench anilla
la o addi i e
GD 2 un il PD 21
5x a week o e- cig
apo
1 hou pe day wi h 1
pu (5 sec) e e y
a e 3 minu es
Ma e nal aping du ing p egnancy
con e s signi ican ce eb o ascula
heal h isk and dys unc ion o
o sp ing which pe sis ill adul hood.
Nguyen
e
al., 2018
[8]
BALB/c
mice
24 emales
Male
o sp ing
n=126
E-liquid wi h
and wi hou
nico ine
(18mg/mL) +
obacco la o
addi i es
6 weeks P GD up o
PD20
2x daily o 30 min
(2x 15 min)
O sp ing om mo he s exposed o e
-
ciga e e ae osols showed sho - e m
memo y de ici s, educed anxie y and
hype ac i i y in adul hood.
Global DNA me hyla ion and
al e a ions in ch oma in modi ica ion
enzymes in he b ain we e ound in all
s ages o he de eloping o sp ing
A chie
e al
.,
2023
[10]
CD1
mice
16
mo he s
160
o sp ing
E-liquid wi h
24mg/mL
nico ine
GD 5 up o PD 7
6x a day, 32
pu s pe
session.
2 pu s pe 60sec
P ena ally e-cig exposed adolescen
and adul o sp ing showed impai ed
locomo o , lea ning, and memo y
unc ion.
P ena al e-cig exposu e also induces
long- e m neu o ascula changes o
neona es by dis up ing pos na al blood
– b ain ba ie (BBB) in eg i y and
wo sening beha io al ou comes.
Legend: GD- Ges a ional Day (Du ing P egnancy) PD- Pos na al Day (A e pa u i ion)
P GD- P eges a ional Day (P e-concep ion)
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The middle ce eb al a e ies (MCAs), is o special
impo ance as hey a e he bigges c anial essels and
supply 80% o he blood low o he b ain. The e o e,
in e ms o ce eb o ascula eac i i y, hese essels
a e he ones ha ha e been examined he mos . A
simple cons ic ion o blockage o MCA p e en s
oxygena ed blood om eaching he b ain
pa enchyma will esul o ischemic s oke and cause
ce eb al edema and issue nec osis.
The s udy o Bu age e al. (2021) on he e ec s o
ma e nal aping on he ce eb o ascula eac i i y in
mice p ogeny, demons a ed ha p ena ally e- apo
exposed pups had mo e han 50% educ ion in
maximal MCA EDD han con ol g oup a 1,3, and 7
mon hs o age, sugges ing ha ma e nal aping, wi h
o wi hou nico ine, con e s signi ican
ce eb o ascula heal h isk/dys unc ion o o sp ing
ha pe sis s in o adul li e. Examina ion o MCA
mic o essels o e-ciga e e exposed pups e ealed
p esence o oxida i e s ess highe han ha o
con ol g oup. Oxida i e s ess impedes a ailabili y o
ni ic oxide (NO), which se es as a asodila o o
MCA, hus play a pi o al ole in b ain blood low
egula ion. The s udy he e o e implies ha ma e nal
aping con ibu es o ce eb o ascula dys unc ion by
educing a ailabili y o NO, which in u n cause
cons ic ion o MCA and impai s b ain blood low.
Changes in sho - e m memo y in mice can be
measu ed by he no el objec ecogni ion (NOR) es ,
whe eby es objec s a e placed in a box oge he wi h
he es animal. A e a amilia iza ion phase, he
animal is emo ed and one o he blocks is eplaced by
a block o di e en shape and colo . Fo he es phase,
he animal is e u ned back o he box, and ime spen
by he animal on explo ing he new block is measu ed.
The idea behind his expe imen is ha a mouse wi h
cogni i e impai men won' be able o ecall he old
i em du ing he es phase and will, as a esul , spend
abou he same amoun o ime in es iga ing each
objec . When es ed, bo h adolescen male and emale
mice p ena ally exposed o e-ciga e e apo exhibi ed
signi ican de e io a ion in objec ecogni ion (Nguyen
e al., 2018; A chie e al., 2023).
On an ele a ed plus maze es ha assess anxie y and
explo a o y ac i i y in mice, Nguyen e al. (2018)
obse ed ha bo h he E-cig (+nic) g oup and E-cig (-
nic) g oup spen a highe pe cen age o ime in he
open a ms, and mo e head dipping compa ed o he
sham g oup. These ac ions a e an indica ion o
educed anxie y le els. In addi ion, o sp ing exposed
o e-ciga e e ae osols, ega dless o nico ine con en ,
showed inc ease in he numbe o cen e c osses
compa ed o he sham g oup, which sugges s ha
exposed mice ha e highe explo a o y and locomo o
ac i i y, which u he implies inc eased cu iosi y and
hype ac i i y. A simila inding is epo ed by A chie
e al. (2023), p ena ally e-cig exposed pups showed
signi ican ly highe locomo o ac i i y in he open
ield es , bu only o emale o sp ing. No signi ican
di e ence was obse ed in p ena ally e-cig exposed
male o sp ing wi h ha o he con ol g oup.
Fu he mo e, Mo is wa e maze es (MWMT) was
pe o med o assess spa ial acquisi ion and e e ence
memo y unc ion in o sp ing a adolescen and adul
age (A chie e al., 2023). No signi ican di e ence was
obse ed in con ol and ea ed g oup in e e ence
memo y howe e , p ena ally e-cig exposed emale
and male g oup had slow lea ning p ocess (lea ning
he loca ion o hidden pla o m) compa ed o con ol
g oup. Mo eo e , only adul male o sp ing had
impai ed lea ning compa ed o con ol g oup.
An e ec o p ena al e-ciga e e exposu e o b ain
de elopmen and cogni ion is also in es iga ed a a
molecula le el (Nguyen e al., 2018; A chie e al.,
2023). Epigene ic modi ica ion, such as DNA
me hyla ion and his one modi ica ions p o ide
mechanisms by which ea ly e en s can in luence
de elopmen , cogni ion, and heal h ou comes. In he
s udy o Nguyen e al. (2018) on he esul o
ma e nal e-ciga e e exposu e o cogni i e and
epigene ic al e a ion, i was ound ha mice whose
in au e ine exposu e was swi ched om ciga e e
smoke o +Nic e-ciga e es, he le el o DNA
me hyla ion was no iceably lowe han when hey
we e exposed o egula ciga e e smoke. Howe e ,
when compa ed wi h con ol g oup exposed wi h
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ambien ai , e-ciga e e smoke exposed o sp ing
showed signi ican ly highe global DNA me hyla ion.
I appea s ha exposu e o ciga e e and ape smoke
has a signi ican co ela ion wi h DNA me hyla ion.
The blood-b ain ba ie (BBB) is a c ucial pa o he
cen al ne ous sys em (CNS), and i is esponsible o
egula ing immune cell a icking be ween he blood
and he b ain as well as p e en ing d ugs om passing
h ough and main aining he homeos asis o he b ain
mic oen i onmen [10]. The s udies o A chie e al.
(2023) ha e also shown ha p ena al e-ciga e e
exposu e al e s exp essions o blood-b ain ba ie
(BBB) componen ma ke s. The s udy has shown ha
ma e nal e-cig exposu e can dec ease he exp ession o
igh junc ion p o eins, as ocy e ma ke and AQP4 a
PD7, PD23, PD45 and PD90. Many a s udy has shown
ha BBB dis up ion has been associa ed wi h he onse
and/ o p og ession o majo neu ological diso de s.
O gan Sys ems
Table 2 lis s s udies ha show e ec o ma e nal
aping o o gan sys ems o o sp ing. Two s udies
p o ided in o ma ion on e ec s on lungs, and ano he
wo s udies on he impac o he li e . O he e ec s
include ca dio ascula and enal ou comes.
Table 2. Animal S udies on Ma e nal E-ciga e e Vapo Exposu e and E ec on O gan Sys ems o O sp ing.
Au ho and
Yea o
Publica ion
Animal
Model
Used
S udy
Popula ion
Ac i e Subs ance
Pe iod o
Exposu e
Findings
Aboaziza
,
E. A., 2022
[1]
Sp ague
Dawley
Ra s
15 dams
E-liquid wi h
and wi hou
nico ine
(18mg/mL) +
F ench anilla
la o addi i e
GD 2 o PD 21
5x a week o e- cig
apo
1 hou pe day wi h 1
pu e e y a e 3
minu es
Signi ican al e a ion
in a e ial
s uc u e and unc ion is obse ed in
adolescen and adul o sp ing.
Impai ed ao ic ela ion in
p ena ally e-cig exposed mice is
obse ed, ega dless o nico ine
con en .
Ca o id a e y s i ness and ao ic
eac i i y de ici is obse ed in
p ena ally e-cig exposed o sp ing
Li
e al
.,
2020
a [2]
BALB/c
mice
24 dams
E-liquid wi h
and wi hou
nico ine
(18mg/mL) +
Tobacco la o
addi i e
6 weeks P GD,
h oughou ges a ion
and lac a ion
(2x a day)
Ma e nal e
-
apo exposu e,
i espec i e o nico ine con en ,
caused impai ed glucose ole ance,
inc eased li e damage and li e
iglyce ide accumula ion in
o sp ing.
We endo ,
M., 2019
[4]
C57BL/6J
mice
No
speci ied
E-liquid wi h
24mg/mL
nico ine
GD 0 o 4 mon hs
( o e ili y ial)
4 weeks P GD un il
GD 5 ( o
implan a ion s udies)
5x a week o e-cig
apo
3 hou s pe day wi h
2 pu s (2 sec) pe
minu e
Exposu es du ing ea ly p egnancy
signi ican ly impai emb yo
implan a ion.
Wang
e al
.
2020
[5]
CD1 mice
1 male, 30
emales
E-liquid wi h
and wi hou
nico ine (16%)
3 hou s
GD 0 o 3 weeks
5x a week o e-cig
apo
3 hou s pe day
Ma e nal exposu e du ing
p egnancy o e-cig ae osols, wi h o
wi hou nico ine, induces
myogenesis wi h dys egula ed ECM
emodeling in a sex-dependen
manne .
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Li
e al
.,
2020
b [6]
BALB/c
mice
24
mo he s
E-liquid wi h
18mg/mL
nico ine +
obacco la o
addi i es
6 weeks P GD un il
lac a ion
2x daily
E
-
ciga e e eplacemen du ing
p egnancy in a low dose se ing
seems o amelio a e he ad e se
impac o ciga e e smoke exposu e
on ma e nal and o sp ing li e
me abolic p o ile in mice.
Li
e al
.,
2019
c [7]
BALB/c
mice
24
mo he s
E-liquid wi h
and wi hou
nico ine
(18mg/mL) +
obacco la o
addi i es
6 weeks P GD up o
lac a ion
2x daily o 30 min
(2x 15 min)
Kidney weigh s is educed in
p ena al smoke-exposed o sp ing
(+nic < -nic < sham) a bi h
Con inuous e- apo exposu e
ad e sely a ec s enal de elopmen ,
by inc easing oxida i e s ess and
ela ed inju y in o sp ing’s kidney.
Chen
e al
.,
2018
[9]
BALB/c
mice
No
speci ied
E-liquid wi h
and wi hou
nico ine
(18mg/mL) +
obacco la o
addi i es
6 weeks P GD o
PD20
2x daily o 30 min
(2x 15 min)
E-ciga e e exposu e du ing
p egnancy ad e sely a ec ed
ma e nal and o sp ing lung heal h.
In u e o e-ciga e e exposu e leads
o abno mali ies in DNA
me hyla ion, wi h o wi hou
nico ine,
Legend: GD- Ges a ional Day (Du ing P egnancy) PD- Pos na al Day (A e pa u i ion)
P GD- P eges a ional Day (P e-concep ion)
Pulmona y sys em
The ou comes o he s udy o Chen e al. (2018) show
ha bo h +Nic and −Nic e-ciga e e exposu e ele a es
ce ain g ow h ac o s in he lung issue o a ec ed
o sp ing and al e s DNA me hyla ion p ocesses,
which con e s ad e se e ec s o bo h o sp ing and
ma e nal lung heal h. A no ewo hy inding in his
s udy is he epo ed inc ease in PDGFα. PDGF
signaling is impo an o lung de elopmen , and
ele a ed PDGF signaling has been linked o lung
ib osis. The s udy sugges s ha ele a ed PDGFα is
caused by he e-ciga e e humec an o la o
addi i es, a he han he nico ine con en o e-liquid.
The s udy o Wang e al. (2020) epo s on he e ec s
o ma e nal e-cig ae osol exposu e h oughou
ges a ion on lung ECM emodeling using in i o
mouse model. The pulmona y ex acellula ma ix
(ECM) es ablishes he s uc u e o he lung's issue
and o e s elas ic ecoil and mechanical s abili y, bo h
o which a e necessa y o heal hy lung unc ion.
Findings sugges ha p ena al e-ciga e e ae osol
exposu e, e en wi h humec an alone, esul s in
myogenic lung p o ile and sex-dependen pulmona y
ECM buildup. Mo eo e , lungs om adul male and
emale o sp ing a e pa icula ly sensi i e o
inc eased ECM deposi ion. I appea s ha ma e nal
aping, wi h o wi hou nico ine, induces myogenesis
in o sp ing wi h dys egula ed ECM emodeling in a
sex-dependen manne . The s udy concludes ha e-
ciga e e use du ing p egnancy is no a sa e subs i u e
o obacco o ciga e e use and aises he isk o lung
p oblems in la e li e.
Hepa ic o gan sys em
Li and associa es (2019, 2020) made an ex ensi e
s udy on he e ec s o ma e nal smoking and aping
on o sp ing li e and i s me abolic ou comes. In hei
2019 s udy, whe e hey look in o he impac o
eplacing obacco smoke wi h e-ciga e e du ing
p egnancy in he me abolic heal h o mice o sp ing, i
was ound ha Replacemen o sp ing had no changes
in body and li e weigh s, compa ed o ciga e e
smoke exposed pups ha had signi ican ly educed
body mass and li e weigh . Mo eo e , e- apo
eplacemen es o ed lipid homeos asis.
J. Bio. &
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I seems ha in mice, swi ching o e-ciga e es du ing
p egnancy appea s o mi iga e he nega i e e ec s o
ciga e e smoke exposu e on ma e nal and o sp ing
li e me abolic p o ile. E-ciga e e apo con ains
lesse quan i y o oxic chemicals han ciga e e
smoke, which likely esul s in ewe in lamma o y
eac ions. The e o e, i is no much o a su p ise ha
using an e-ciga e e ins ead o obacco smoke du ing
p egnancy had less o an ad e se e ec (Li e al.,
2020).
Howe e , on a subsequen s udy, compa ing e-
ciga e e exposu e, wi h and wi hou nico ine, wi h
ha o a con ol g oup exposed o ambien ai ,
o sp ing o dams exposed o nico ine-con aining e-
apo de eloped glucose in ole ance associa ed wi h
impai ed insulin signaling elemen , and had
inc eased hepa ic gluconeogenesis, as well as
inc eased hepa ic iglyce ide accumula ion
associa ed wi h inc eased de-no o lipogenesis. On he
o he hand, p ena al exposu e o nico ine ee e- apo
had led o inc eased oxida i e s ess and
in lamma ion in he o sp ing’s li e , impai ed li e
mi ochond ial heal h, and impai ed glucose
me abolism. O e all, his sugges ha ma e nal e-
apo exposu e, i espec i e o nico ine con en ,
caused impai ed glucose ole ance, inc eased li e
damage and li e iglyce ide accumula ion in
o sp ing (Li e al., 2020).
Ca dio ascula o gan sys em
The s udy o Aboaziza e al. (2022) desc ibes he
consequence o ma e nal aping on cen al a e ial
s i ness and ao ic eac i i y in adolescen and adul
mice o sp ing. Pe ina al e-ciga e e exposed
o sp ing we e ound o ha e wo o h ee- old
inc ease in ca o id a e y s i ness and 20 – 30%
educ ion in ao ic eac i i y compa ed o con ol
g oups. Inc easing ma e nal exposu e and nico ine
le els in he e-liquid did no c ea e a dose-dependen
e ec on he o sp ing’s ascula ou comes. This
inding implies ha ma e nal aping du ing
p egnancy, ega dless o nico ine con en , leads o
maladap a ion in ascula de elopmen ha pe sis
in o adul li e o o sp ing.
Renal o gan sys em
A mice s udy conduc ed by Li e al. (2019) on he
e ec s o ma e nal e-ciga e e apo exposu e on
enal heal h in he o sp ing showed ha eplacemen
o obacco ciga e es wi h e-ciga e es esul ed in
inc eased o al ROS and mi ochond ial speci ic ROS,
and imp o emen o o e all enal de elopmen and
unc ion compa ed o con inuous ciga e e smoke
exposu e du ing p egnancy. Howe e , con inuous e-
apo exposu e du ing p egnancy was s ill ound o be
de imen al o e al de elopmen , wi h inc eased
kidney ma ke s o oxida i e s ess, enal
in lamma ion and ib osis in he adul o sp ing,
independen o nico ine.
Bi h Pa ame e s
The impac o ma e nal e-ciga e e exposu e on bi h
pa ame e s such as bi h weigh and li e size o o sp ing
is gi en in Table 3. Eigh o he o al 10 publica ions
examined p o ided in o ma ion on hese wo pa ame e s.
In all 10 s udies analyzed, nei he inc eased in an ile
mo ali y no s illbi hs we e no ed. This is alid o
bo h pa en al exposu e o e-ciga e es in he weeks
p eceding p egnancy (Chen e al., 2017; We endo e
al., 2019; Li e al., 2019 & 2020) as well as o
ma e nal p ena al exposu e beginning a concep ion
(Wang e al., 2020; Bu age e al., 2021; Aboaziza e
al., 2023; A chie e al., 2023). Mos o he s udies
epo ed ha p ena al exposu e o e-ciga e e apo ,
wi h o wi hou nico ine, had no e ec on li e size
(Chen e al., 2017; Wang e al., 2020; Bu age e al.,
2021; Aboaziza e al., 2023; A chie e al., 2023) and
bi h weigh (Chen e al., 2017; Li e al., 2019;
We endo e al., 2019; Wang e al., 2020; Bu age e
al., 2021; Aboaziza e al., 2023) when compa ed o
he con ol g oup exposed wi h ambien ai . Some
s udies con adic hese indings as hey ha e
obse ed educ ion in bi h weigh (Chen e al., 2017;
We endo e al., 2019; Li e al., 2020; A chie e al.,
2023) and li e size (We endo e al., 2019) in pups
o e-ciga e e exposed dams. I is also no ed ha
o sp ing wi h educed weigh a bi h g adually ca ch
up wi h ha o he sham g oup la e in adul hood.
J. Bio. &
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This inding is in consonance wi h o he s udies
( obacco exposed s sham) which epo ed ha any
weigh di e ences among o sp ing, ega dless o
exposu e g oup, will le el ou la e in li e. Howe e , a
de ia ion om his obse a ion is epo ed in he
s udy o We endo (2019), whe e weigh educ ion in
adul hood is obse ed bu only in emale o sp ing,
while Chen, e al. (2018) also epo ed he same end
o weigh educ ion, bu only o male o sp ing.
Table 3. Animal S udies on Ma e nal E-ciga e e Vapo Exposu e and E ec on Bi h Pa ame e s.
Au ho and
Yea o
Publica ion
Animal Model
Used
S udy
Popula ion
Ac i e
Subs ance
Pe iod o
Exposu e
Findings
Aboaziza
, E.
A., 2022
[1]
Sp ague
Dawley Ra s
15 dams
E
-
liquid wi h and
wi hou nico ine
(18mg/mL) +
F ench anilla
la o addi i e
GD 2 o PD 21
5x a week o e- cig
apo
1 hou pe day wi h 1
pu e e y a e 3
minu es
Li e size and body mass a bi h we e
no di e en be ween g oups.
Highe body a (BF) mass and lowe
lean body mass is obse ed in e-cig
exposed o sp ing (Ecig0)
Bu age
e
al., 2021
[3]
Sp ague
Dawley Ra s
15 mo he s
E-liquid wi h and
wi hou nico ine
(18mg/mL) +
F ench anilla
la o addi i e
GD 2 un il PD 21
5x a week o e- cig
apo
1 hou pe day wi h 1
pu (5 sec) e e y a e 3
minu es
Body mass a bi h and a weaning we e
no di e en be ween g oups.
No di e ence in li e size wi hin
exposed and con ol dams.
An h opome ic measu es a e no
signi ican ly di e en wi hin any age o
by exposu e g oup
We endo ,
M., 2019
[4]
C57BL/6J
mice
No
speci ied
E-liquid wi h
24mg/mL
nico ine
GD 0 o 4 mon hs ( o
e ili y ial)
4 weeks P GD un il GD
5 ( o implan a ion
s udies)
5x a week o e-cig apo
3 hou s pe day wi h 2
pu s (2 sec) pe minu e
Delay onse o i s li e , and cause
sligh educ ion on li e size.
No e ec on o e all bi h weigh , bu
caused educed weigh in emale
o sp ing
Wang
e al
.
2020
[5]
CD-1 mice
1 male, 30
emales
E
-
liquid wi h and
wi hou nico ine
(16%)
GD 0 o 3 weeks
5x a week o e-cig apo
3 hou s pe day
E
-
cig ae osol exposu e had no e ec on
p egnancy incidence, li e size, o
male- o- emale o sp ing sex a io.
Li
e al
.,
2019
c [6]
BALB/c mice
24 mo he s
E
-
liquid wi h
nico ine
(18mg/mL) +
obacco la o
addi i es
6 weeks P GD un il
lac a ion
2x daily o 30 min (2x
15 min)
Bi h weigh is educed o p ena ally e
-
cig exposed o sp ing, ega dless o
nico ine concen a ion.
Nguyen
e
al., 2018
[7]
BALB/c mice
24 emales
Male
o sp ing
n=126
E
-
liquid wi h and
wi hou nico ine
(18mg/mL) +
obacco la o
addi i es
6 weeks P GD up o
PD20
2x daily o 30 min (2x
15 min)
The e was no di e ence in bi h
weigh s o mo bidi y be ween he
exposu e s a us o he dams.
Chen
e al
.,
2018
[9]
BALB/c mice
No
speci ied
E
-
liquid wi h and
wi hou nico ine
(18mg/mL) +
obacco la o
addi i es
6 weeks P GD o PD20
2x daily o 30 min (2x
15 min)
No di e ence in body weigh o o gan
weigh a bi h among he o sp ing
g oups, bu weigh educ ion is
obse ed in e-cig (+nic) pups in
adul hood.
A chie
e al
.,
2023
[10]
CD1 mice
16 mo he s
160
o sp ing
E-liquid wi h
24mg/mL
nico ine
GD 5 up o PD 7
6x a day, 32 pu s pe
session.
2 pu s pe 60sec
No di e ence was obse ed in li e size
be ween con ol and exposed o sp ing.
Bi h weigh and b ain-body weigh
a io is signi ican ly educed in e-cig
exposed o sp ing.
Legend: GD- Ges a ional Day (Du ing P egnancy) PD- Pos na al Day (A e pa u i ion)
P GD- P eges a ional Day (P e-concep ion)
