(PS13-B30) Maternal E-cigarette Use on Postpartum Depression and Anxiety: A Growing Public Health Threat for Vulnerable Mothers

Background: Despite national reductions in combustible cigarette use, the recent popularization of electronic cigarettes (e-cigarettes) has led to an alarming resurgence of nicotine consumption in U.S. youth and young adults (CDC, 2022). E-cigarette consumption is particularly concerning during pregnancy as nicotine exposure produces negative health consequences for mother and fetus (CDC, 2020). Despite the public health threat of e-cigarette use during pregnancy, particularly for young adult women, limited research has examined e-cigarette use practices in pregnancy and subsequent postpartum mental health. Further, factors like age, race/ethnicity, and education influence maternal cigarette use (Drake et al., 2018), but limited work has established whether these factors will predict e-cigarette use in a pregnant population. Though cigarette use in pregnancy is associated with maternal postpartum depression (Salimi et al., 2015), no work to our knowledge has compared e-cigarette, cigarette, and dual use in pregnancy on maternal postpartum depression and anxiety. This project aims to 1) investigate which sociodemographic characteristics (i.e., age, race, education) are associated with e-cigarette, cigarette, and dual use in pregnant women and 2) examine associations among e-cigarette, cigarette, and dual use practices in pregnancy on postpartum depression and anxiety.

Methods: For this project, we were approved to use the Pregnancy Risk Assessment Monitoring System (PRAMS), a national, cross-sectional survey conducted by the Centers of Disease Control and Prevention. This large dataset (N=245,431) is diverse in terms of race (21.3% Black, 62.5% White, 6.3% American Indian/Alaska Native, 3.6% Asian, .5% Native Hawaiian, 6.1% Other), ethnicity (19.2% Hispanic/Latina), and age (22.2% young adults). 8.4% of mothers in our sample endorsed smoking cigarettes during pregnancy (n=20,601), while 1.3% of mothers endorsed using e-cigarettes during pregnancy (n=2,576). A large number of mothers endorsed post-partum depression (13.9%) or anxiety (9.6%). Descriptives, ANOVAs, and chi-squares will be used to examine associations between sociodemographic characteristics and e-cigarette, cigarette, or dual use. Main analyses for aim 2 will be conducted utilizing multivariate regression with complex sample weighting, controlling for relevant demographics from aim 1 and pre- and peripartum depression and anxiety.

Implications: E-cigarette use is a growing public health concern in the U.S., likely to impact the health of pregnant adults and have enduring developmental repercussions on their children. It is imperative that we understand e-cigarette and cigarette practices during pregnancy and subsequent postpartum mental health to identify targets for preventative CBT interventions and improve the mental and physical health outcomes for this vulnerable, at-risk population, with a specific focus on the impacts of e-cigarette use for racially minoritized women who are often excluded from tobacco research.