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

项目总结/摘要 在过去的十年中，电子烟（EC）的使用或vaping迅速增加，最明显的是 年轻人和妇女。由于感知危害减少，一些专用可燃香烟 (CC)怀孕或计划怀孕的吸烟者可能会转向vaping或开始双重使用，以减少 CC吸烟在独家EC使用中，有些人可能会在怀孕期间戒烟或减少吸烟。在双 使用者，怀孕期间也可能发生动态变化，包括停止使用电子烟和/或吸烟。 目前，关于妊娠期间使用氨基甲酸乙酯对母婴健康影响的研究有限。 对怀孕期间使用EC的动态变化的健康后果知之甚少。 此外，这些动态变化的决定因素在EC的使用还没有得到表征。 我们提出了一个为期2年的二级数据分析，以检查母亲使用EC的动态变化 在怀孕前后（怀孕前、怀孕中和怀孕后），这些变化的决定因素及其影响 关于母婴健康的报告。我们将使用来自两项大型美国国家研究的现有和新的待定数据 补充数据：1）妊娠风险评估监测系统（PRAMS），N= 108，110 2016-2018年第8阶段的现有母亲加上2019-2021年第9阶段的新母亲，以及2） 烟草与健康的人群评估（PATH）研究，N= 4，392例第1-4波的现有妊娠 2013-2017年期间，加上2018-2019年第5波的新怀孕和2020年的成人电话调查。 女性受试者报告其在怀孕前3个月内使用EC/CC，在过去3个月内 怀孕后，和怀孕后（产后）。我们将重点关注EC用途：的以下动态变化： 中断，转换，和复发。潜在的决定因素包括社会人口统计学、怀孕 意图和特征，基线EC使用和产品特征，EC使用的风险感知，同时 物质使用和调查时间。产前结局包括妊娠期体重增加和妊娠期 持续时间新生儿结局包括小于胎龄儿出生、分娩方式和婴儿身长 住院。产后结果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 怀孕具体目标2是评估与EC使用动态变化相关的健康结果， 在怀孕期间和之后。我们已经收到了来自两项国家研究的二级数据， 关键变量的分布，并进行了初步分析，以确保研究有足够的统计功效 目标。这项创新的研究可以为指导欧盟产品的监管提供关键证据。

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.