Vaping in pregnancy: A systematic review.
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ABSTRACT: Introduction
Smoking in pregnancy increases the risk of negative health outcomes. Vaping can be effective for smoking cessation in non-pregnant populations. We conducted a systematic review of vaping in pregnancy, covering prevalence, patterns of use, reasons for use, smoking cessation and health effects.Methods
Five academic databases were searched on 17 February 2020. Studies reporting prevalence, patterns, reasons, cessation or health effects of vaping in pregnancy were included; animal and in-vitro studies were excluded. A narrative review was used, with risk of bias assessed using Hoy and colleague's tool, the Newcastle-Ottawa scale and the Consolidated Criteria for reporting Qualitative Research.Results
Twenty-three studies were identified: 11 survey, seven qualitative, three cohort and two secondary analyses of RCTs. Prevalence of vaping in pregnancy (four studies) was between 1.2% and 7.0% overall, and <1% among non-smokers. Twelve studies reported patterns of use, but findings were inconsistent. Twelve of fourteen studies asking why pregnant women vaped reported that most vaped to reduce or quit smoking. Mixed findings were reported from six studies on smoking cessation. Of three studies with health-related outcomes, two were underpowered and one reported similar birthweights for babies born to non-smokers and women who vaped, with both higher (P<.0001) than the birthweight of babies born to smokers.Conclusions
There were insufficient data to draw conclusions about prevalence, patterns and effects of vaping in pregnancy on smoking cessation. The limited literature suggests that vaping in pregnancy has little or no effect on birthweight.
SUBMITTER: Calder R
PROVIDER: S-EPMC8372638 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC7084341 | biostudies-literature
Project description:BackgroundWomen are commonly prescribed a variety of medications during pregnancy. As most organ systems are affected by the substantial anatomical and physiological changes that occur during pregnancy, it is expected that pharmacokinetics (PK) (absorption, distribution, metabolism, and excretion of drugs) would also be affected in ways that may necessitate changes in dosing schedules. The objective of this study was to systematically identify existing clinically relevant evidence on PK changes during pregnancy.Methods and findingsSystematic searches were conducted in MEDLINE (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (Ovid), and Web of Science (Thomson Reuters), from database inception to August 31, 2015. An update of the search from September 1, 2015, to May 20, 2016, was performed, and relevant data were added to the present review. No language or date restrictions were applied. All publications of clinical PK studies involving a group of pregnant women with a comparison to nonpregnant participants or nonpregnant population data were eligible to be included in this review. A total of 198 studies involving 121 different medications fulfilled the inclusion criteria. In these studies, commonly investigated drug classes included antiretrovirals (54 studies), antiepileptic drugs (27 studies), antibiotics (23 studies), antimalarial drugs (22 studies), and cardiovascular drugs (17 studies). Overall, pregnancy-associated changes in PK parameters were often observed as consistent findings among many studies, particularly enhanced drug elimination and decreased exposure to total drugs (bound and unbound to plasma proteins) at a given dose. However, associated alterations in clinical responses and outcomes, or lack thereof, remain largely unknown.ConclusionThis systematic review of pregnancy-associated PK changes identifies a significant gap between the accumulating knowledge of PK changes in pregnant women and our understanding of their clinical impact for both mother and fetus. It is essential for clinicians to be aware of these unique pregnancy-related changes in PK, and to critically examine their clinical implications.
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