A link between vaping when pregnant and sharing a bed with baby has emerged as a potential risk factor for deaths among infants.
A new study, published by researchers at the Universities of Auckland and Otago, looked at 101 sudden unexpected infant deaths (SUDI) in New Zealand between 2022 and 2023.
They had detailed information about maternal nicotine exposure and the infant's sleep environment for 66 of the cases.
Smoking and/or vaping was recorded in nearly three-quarters of the 66 cases that researchers had detailed information for. Nearly 70% of infants had died while bed-sharing.
Maternal vaping was reported in half of the cases involving direct bed sharing – compared to one in five cases where bed sharing was not reported.
Of the deaths that occurred during direct bed sharing, 84.8% involved maternal smoking or vaping.
The study's lead author Professor Ed Mitchell said it was "concerning" that vaping "may be showing a similar pattern of risk as smoking, especially when combined with bed sharing".
Smoking has long been one of the greatest risk factors for the sudden death of infants, raising questions about pregnancy advice.
"This raises the possibility that the effects of nicotine itself, rather than how nicotine is delivered, may be contributing to infant vulnerability," Mitchell said.
"Our findings suggest we need to consider all nicotine exposure during pregnancy, particularly when it is combined with bed sharing."
Researchers stressed that the study did not prove that vaping was a cause of death for infants.
“Uncertainty is not reassurance,” University of Otago professor Barry Taylor, one of the co-authors, said.
“When the possible consequence is an infant death, a precautionary approach is warranted while the evidence develops.”
Researchers called for public messaging around pregnancy to be changed.
“Vaping has been widely approached as a safer alternative to smoking and a smoking cessation aid, including in pregnancy," Mitchell said.
"Our findings suggest we need to consider all nicotine exposure during pregnancy, particularly when it is combined with bed sharing.”
In a statement to 1News, Jonathan Devery, chair of the Vaping Industry Association of New Zealand, said the organisation agreed that nicotine use during pregnancy and around newborns "should be strongly discouraged".
He said that because the study was a case series with no control group, it could not be established that vaping independently increased the risk of SUDI or demonstrated a causal relationship.
"Smoking, vaping and infant sleep practices frequently overlap, making it difficult to separate their individual effects.
"The authors appropriately call for further research to better understand the association between vaping and SUDI."
He said that until then, pregnancy should be treated as smoke-, vape-, and nicotine-free.
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