AIM: Electronic cigarette usage has become increasingly popular in recent years, advertised as a safe alternative to smoking. However, the long-term impact on prenatal development is not well understood. The aim of this systematic review and meta-analysis is to investigate the impact of prenatal electronic cigarette exposure on self-regulation and motor development in existing human and animal research and to identify the common assessment measures.

METHODS: 2116 records from six databases were retrieved, of which 70 (56 human; 14 animal) were retained for review. Random-effects meta-analyses were conducted on eligible studies.

RESULTS: The emerging animal literature provides evidence for the impact of electronic cigarette exposure on offspring development. Meta-analysis results of 42 eligible human studies indicated that prenatal exposure to nicotine or cannabis by combustible or electronic cigarette was associated with deficits in cognitive, emotional, and behavioural self-regulatory domains, as well as motor function and neuromotor development. Only one human study included electronic cigarettes.

CONCLUSIONS: The combined findings of human and animal literature suggest overlapping influences of combustible and electronic cigarettes across self-regulation and motor domains. Given the policy implications, there is an urgent need for more research on electronic cigarette use in humans during pregnancy.