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Abstract Background As e-cigarettes gain popularity as potential tobacco cessation aids, concerns arise about their dual use with traditional cigarettes, especially among pregnant women, potentially subjecting both women and fetuses to heightened risks. This systematic review and meta-analysis aimed to determine the overall prevalence of dual use of tobacco smoking and e-cigarette use in pregnant women. Methods A literature search was conducted across databases including PubMed, Embase, Web of Science, and Cochrane on October 20, 2023. The included studies reported the number of pregnant women and the count of those who were dual users. Quality assessment was undertaken using the JBI tool. The pooled prevalence of dual use was determined via a random-effects model. All statistical analyses were executed using R software, version 4.3. PROSPERO: CRD42023486020. Results Eighteen studies were analyzed, encompassing 5,983,363 pregnant women. The meta-analysis indicated an overall prevalence of 4.6% (95% CI: 2.0-10.3) for dual users with significant heterogeneity (I2 = 100%). Subgroup analysis based on the country showed a prevalence of 4.9% (95% CI: 2.0 to 11.6) for USA and 8.1% (95% CI: 0.00 to 1.00) for UK. Meta-regression revealed reduction of prevalence of dual use from 2019 to 2023. A potential publication bias was indicated by the LFK index and the Doi plot. Conclusion The dual consumption of e-cigarettes and traditional tobacco in pregnant women is a significant health concern, with a notable prevalence. Given the established risks of tobacco smoking during pregnancy and the uncertainties surrounding e-cigarettes, more comprehensive research and public health interventions are urgently needed to address this issue.

Abstract Background People living with HIV (PLWH) are more vulnerable to infectious and non-infectious comorbidities due to chronic inflammation and immune dysfunction. Air pollution is a major global health risk, contributing to millions of deaths annually, primarily from cardiovascular and respiratory diseases. However, the link between air pollution and mortality risk in PLWH is underexplored. This systematic review assesses the association between exposure to pollutants such as particulate matter (PM), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) and mortality risk in PLWH. Methods A systematic search of PubMed, Web of Science, and Embase was conducted for studies published up to August 2024. Eligibility criteria included cohort, case-control, and cross-sectional studies assessing air pollution exposure and mortality in PLWH. Nested-Knowledge software was used for screening and data extraction. The Newcastle-Ottawa Scale was applied for quality assessment. A narrative approach and tabular summarization were used for data synthesis and presentation. Results Nine studies, mostly from China, demonstrated a significant association between long-term exposure to PM1, PM2.5, and PM10 and increased risks of AIDS-related and all-cause mortality in PLWH. Hazard ratios for mortality increased by 2.38–5.13% per unit increase in PM concentrations, with older adults (> 60), females, and those with lower CD4 counts (