Determinants and health effects of dynamic changes in e-cigarette use before, during, and after pregnancy

项目摘要/摘要 在过去十年中，电子烟(EC)的使用或蒸发迅速上升，最显著的是 年轻人口和妇女。由于减少了感知到的危害，一些独有的可燃香烟 (Cc)怀孕或计划怀孕的吸烟者可改用蒸发或开始两用，以减少 密歇根吸烟。在独家使用的EC中，一些可能会在怀孕期间戒烟或减少蒸发。在DUAL中 对于使用者来说，怀孕期间也可能发生动态变化，包括停止蒸发和/或吸烟。 目前，关于孕期使用EC对母婴健康影响的研究有限。 对于怀孕期间使用EC的动态变化对健康的影响更是知之甚少。 此外，EC使用量的这些动态变化的决定因素尚未确定。 我们建议进行为期两年的二级数据分析，以检验产妇使用EC的动态变化 在怀孕前后(怀孕前、怀孕期间和怀孕后)，这些变化的决定因素及其影响 关于孕产妇和婴儿健康。我们将使用来自美国两项大型国家研究的现有数据和新的待定数据 补充数据：1)妊娠风险评估监测系统(PRAMS)，N=108,110 2016-2018年第8阶段的现有母亲以及2019-2021年第9阶段的新母亲，以及2) 烟草与健康的人口评估(PATH)研究，N=4,392例第1-4波中的现有妊娠 2013-2017年期间，加上2018-2019年期间第5波的新怀孕人数和2020年的成人电话调查。 女性参与者报告了她们在怀孕前3个月内，在最后3个月内使用EC/CC的情况 怀孕期间和怀孕后(产后)。我们将重点关注EC使用的以下动态变化： 停止、转换和复发。潜在决定因素包括社会人口统计数据、怀孕 意图和特征、基准EC使用和产品功能、EC使用的风险认知、并发 物质使用情况和调查时间。产前结局包括妊娠体重增加和妊娠 持续时间。新生儿结局包括小于胎龄儿的出生、分娩方式和婴儿的长度。 住院治疗。产后结局包括母乳喂养和产后抑郁症。 具体目标1是检查EC使用之前、期间和之后动态变化的决定因素 怀孕了。具体目标2是评估与以前EC使用的动态变化相关的健康结果， 在怀孕期间和怀孕后。我们从两个国家的研究中收到了二手数据，已经检查了 关键变量的分布，并进行了初步分析，以确保有足够的统计力量进行研究 目标。这项创新研究可以提供关键证据来指导对EC产品的监管。

PROJECT SUMMARY/ABSTRACT Rapid rise in e-cigarette (EC) use or vaping has been observed in the past decade, most notably among young populations and women. As a result of perceived harm reduction, some exclusive combustible cigarette (CC) smokers who are pregnant or planning a pregnancy may switch to vaping or initiate dual use to reduce CC smoking. Among exclusive EC uses, some may quit or reduce vaping during pregnancy. Among dual users, dynamic changes may also occur during pregnancy including discontinuing vaping and/or smoking. Currently, there is limited research on maternal and infant health effects related to EC use during pregnancy. Even less is known about the health consequences of dynamic changes in EC use during pregnancy. Furthermore, the determinants of these dynamic changes in EC use have not been characterized. We propose a 2-year secondary data analysis to examine the dynamic changes in maternal EC use around the time of pregnancy (before, during, and after), the determinants of these changes, and their effects on maternal and infant health. We will use existing and new pending data from two large U.S. national studies with complementary data: 1) the Pregnancy Risk Assessment Monitoring System (PRAMS) with N=108,110 existing mothers in the phase 8 during 2016-2018 plus new mothers in phase 9 during 2019-2021, and 2) the Population Assessment of Tobacco and Health (PATH) Study with N=4,392 existing pregnancies in waves 1-4 during 2013-2017 plus new pregnancies in wave 5 during 2018-2019 and Adult Telephone Survey in 2020. Female participants reported their EC/CC use within the 3 months before pregnancy, during the last 3 months of pregnancy, and after pregnancy (postpartum). We will focus on the following dynamic changes in EC use: discontinuing, switching, and relapsing. Potential determinants include socio-demographics, pregnancy intention and characteristics, baseline EC use and product features, risk perception of EC use, concurrent substance use, and time of survey. Prenatal outcomes include gestational weight gain and gestational duration. Neonatal outcomes include small-for-gestational-age birth, mode of delivery, and length of infant hospital stay. Postpartum outcomes include breastfeeding and postpartum depression. Specific Aim 1 is to examine determinants of dynamic changes in EC use before, during, and after pregnancy. Specific Aim 2 is to assess health outcomes associated with dynamic changes in EC use before, during, and after pregnancy. We have received secondary data from both national studies, have examined distributions of key variables, and have run preliminary analyses to ensure sufficient statistical power for study aims. This innovative study can yield critical evidence to guide regulation of EC products.