Introduction:
The emergence of electronic nicotine delivery systems (ENDS) has significantly influenced smoking patterns during pregnancy. There has been a global increase in the use of electronic nicotine delivery systems (ENDS) during pregnancy. While ENDS are often perceived as a safer option compared to traditional cigarettes, their potential effects on perinatal outcomes remain unclear. This systematic review sought to investigate the impact of ENDS use during pregnancy.

Methods:
We conducted a systematic literature review using the Scopus and Medline (PubMed) databases to identify studies examining the effects of electronic nicotine delivery systems (ENDS) on pregnancy. The search was restricted to English-language publications. The scope of this research was restricted to studies involving human participants, with animal studies being excluded from the analysis.

Results:
There is a correlation between ENDS use and an elevated risk of adverse perinatal outcomes, such as small for gestational age (SGA) infants, preterm birth (PB), and low birth weight (LBW). While ENDS are often seen as a less harmful option than traditional cigarettes, the evidence suggests that both pose substantial risks to fetal health. The most favorable perinatal outcomes are consistently observed among nonsmokers, emphasizing the importance of complete abstinence from both traditional cigarettes and ENDS for pregnant women.

Conclusions:
The use of ENDS during pregnancy is linked to substantial adverse perinatal outcomes. These findings underscore the importance of public health policies that advocate for complete abstinence from both traditional cigarettes and ENDS among pregnant women to optimize perinatal health.