Impact of E-Cigarettes on Fetal and Neonatal Lung Development: The Influence of Oxidative Stress and Inflammation

Abstract

Electronic cigarettes (e-cigs) recently increased their popularity as "safer" alternatives to traditional tobacco smoking, including among pregnant women. However, the effect of e-cig exposure on fetal and neonatal developing lungs remains poorly investigated. In this review, we analysed the impact of e-cig aerosol components (e.g., nicotine, solvents, and flavouring agents) on respiratory system development. We particularly emphasized the role of e-cig-related oxidative stress and inflammation on lung impairment. Nicotine contained in e-cigs can impair lung development at anatomical and molecular levels. Solvents and flavours induce inflammation and oxidative stress and contribute to compromising neonatal lung function. Studies suggest that prenatal e-cig aerosol exposure may increase the risk of future development of respiratory diseases in offspring, such as asthma and chronic obstructive pulmonary disease (COPD). Preventive strategies, such as smoking cessation programs and antioxidant supplementation, may be essential for safeguarding respiratory health. There is an urgent need to explore the safety profile and potential risks of e-cigs, especially considering the limited studies in humans. This review highlights the necessity of regulating e-cig use during pregnancy and promoting awareness of its potential consequences on fetal and neonatal development.

Keywords: COPD; air pollution; asthma; e-cigarette; lung development; neonates; oxidative stress; pregnancy.

Figure 1

Stages of normal lung development and impact of adverse exposures.

Figure 2

The role of e-cig-induced oxidative stress on the airways.

Figure 3

Multiple integrated prevention strategies to influence e-cig use during pregnancy.