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In an effort to diminish adverse developmental effects of exposure to cigarette smoking, pregnant women, and women of reproductive age, are increasingly turning to electronic nicotine delivery systems (ENDS), such as e\u2010cigarettes, as an alternative. Given that health risks associated with ENDS use during pregnancy are largely unknown, there is an acute need to determine risks vs. benefits of e\u2010cigarette use by pregnant women. While the most recent Surgeon General's Report on the \u201cHealth Consequences of Smoking\u201d states that <jats:italic>\u201cthe evidence is sufficient to infer that nicotine adversely affects maternal and fetal health during pregnancy<\/jats:italic>, <jats:italic>contributing to multiple adverse outcomes<\/jats:italic>,<jats:italic>\u201d<\/jats:italic> it remains unclear whether use of ENDS represents a \u201csafer alternative\u201d to tobacco smoking during pregnancy. This is due, in part, to the lack of sufficient and conclusive evidence concerning whether or not maternal e\u2010cigarette use adversely affects embryonic\/fetal development. While several recent developmental studies have challenged the safety of nicotine inhalation via ENDS, the <jats:italic>true<\/jats:italic> risks of smoking e\u2010cigarettes during the first trimester of pregnancy\u2014the period of organogenesis\u2014are largely unknown. Moreover, evidence is emerging that even <jats:italic>nicotine\u2010free<\/jats:italic> e\u2010cigarette aerosols may harm the developing conceptus, suggesting that components of e\u2010cigarette liquid, including flavorings, may be developmentally toxicity. Focused human epidemiological analyses, and carefully designed animal studies are critically needed to address the question of the safety of ENDS use during pregnancy.<\/jats:p>","DOI":"10.1002\/bdr2.1571","type":"journal-article","created":{"date-parts":[[2019,8,10]],"date-time":"2019-08-10T05:14:12Z","timestamp":1565414052000},"page":"1294-1301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Developmental toxicity of e\u2010cigarette aerosols"],"prefix":"10.1002","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6456-8103","authenticated-orcid":false,"given":"Robert M.","family":"Greene","sequence":"first","affiliation":[{"name":"Department of Oral Immunology and Infectious Diseases, Division of Craniofacial Development and Anomalies School of Dentistry, University of Louisville  Louisville Kentucky 40202"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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