Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies
Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies
Background: The preconception period represents transgenerational opportunities to optimize modifiable risk factors associated with both short and long-term adverse health outcomes for women, men, and children. As such, preconception care is recommended to couples during this time to enable them to optimise their health in preparation for pregnancy. Historically, preconception research predominately focuses on maternal modifiable risks and health behaviours associated with pregnancy and offspring outcomes; limited attention has been given to inform paternal preconception health risks and outcomes. This systematic review aims to advance paternal preconception research by synthesising the current evidence on modifiable paternal preconception health behaviours and risk factors to identify associations with pregnancy and/or offspring outcomes. Methods: Medline, Embase, Maternity and Infant care, CINAHL, PsycINFO, Scopus, and ISI Proceedings were searched on the 5th of January 2023, a date limit was set [2012–2023] in each database. A Google Scholar search was also conducted identifying all other relevant papers. Studies were included if they were observational, reporting associations of modifiable risk factors in the preconception period among males (e.g., identified as reproductive partners of pregnant women and/or fathers of offspring for which outcomes were reported) with adverse pregnancy and offspring outcomes. Study quality was assessed using the Newcastle–Ottawa Scale. Exposure and outcome heterogeneity precluded meta-analysis, and results were summarised in tables. Results: This review identified 56 cohort and nine case control studies. Studies reported on a range of risk factors and/or health behaviours including paternal body composition (n = 25), alcohol intake (n = 6), cannabis use (n = 5), physical activity (n = 2), smoking (n = 20), stress (n = 3) and nutrition (n = 13). Outcomes included fecundability, IVF/ISCI live birth, offspring weight, body composition/BMI, asthma, lung function, leukemia, preterm birth, and behavioural issues. Despite the limited number of studies and substantial heterogeneity in reporting, results of studies assessed as good quality showed that paternal smoking may increase the risk of birth defects and higher paternal BMI was associated with higher offspring birthweight. Conclusion: The current evidence demonstrates a role of paternal preconception health in influencing outcomes related to pregnancy success and offspring health. The evidence is however limited and heterogenous, and further high-quality research is needed to inform clinical preconception care guidelines to support men and couples to prepare for a health pregnancy and child.
Modifiable, Offspring outcomes, Paternal, Preconception, Pregnancy outcomes, Risk factor, Premature Birth, Humans, Risk Factors, Live Birth, Male, Pregnancy, Birth Weight, Female, Fathers, Child, Infant, Newborn, Preconception Care
509
Carter, Tristan
d32affa0-004c-4a98-aa1b-024eb3defd47
Schoenaker, Danielle
84b96b87-4070-45a5-9777-5a1e4e45e818
Adams, Jon
12b2c9e7-6fdb-41e3-8d4d-33a44ceffb3e
Steel, Amie
947b68e3-582e-4040-b2c0-1927f0d30932
16 March 2023
Carter, Tristan
d32affa0-004c-4a98-aa1b-024eb3defd47
Schoenaker, Danielle
84b96b87-4070-45a5-9777-5a1e4e45e818
Adams, Jon
12b2c9e7-6fdb-41e3-8d4d-33a44ceffb3e
Steel, Amie
947b68e3-582e-4040-b2c0-1927f0d30932
Carter, Tristan, Schoenaker, Danielle, Adams, Jon and Steel, Amie
(2023)
Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies.
BMC Public Health, 23 (1), , [509].
(doi:10.1186/s12889-023-15335-1).
Abstract
Background: The preconception period represents transgenerational opportunities to optimize modifiable risk factors associated with both short and long-term adverse health outcomes for women, men, and children. As such, preconception care is recommended to couples during this time to enable them to optimise their health in preparation for pregnancy. Historically, preconception research predominately focuses on maternal modifiable risks and health behaviours associated with pregnancy and offspring outcomes; limited attention has been given to inform paternal preconception health risks and outcomes. This systematic review aims to advance paternal preconception research by synthesising the current evidence on modifiable paternal preconception health behaviours and risk factors to identify associations with pregnancy and/or offspring outcomes. Methods: Medline, Embase, Maternity and Infant care, CINAHL, PsycINFO, Scopus, and ISI Proceedings were searched on the 5th of January 2023, a date limit was set [2012–2023] in each database. A Google Scholar search was also conducted identifying all other relevant papers. Studies were included if they were observational, reporting associations of modifiable risk factors in the preconception period among males (e.g., identified as reproductive partners of pregnant women and/or fathers of offspring for which outcomes were reported) with adverse pregnancy and offspring outcomes. Study quality was assessed using the Newcastle–Ottawa Scale. Exposure and outcome heterogeneity precluded meta-analysis, and results were summarised in tables. Results: This review identified 56 cohort and nine case control studies. Studies reported on a range of risk factors and/or health behaviours including paternal body composition (n = 25), alcohol intake (n = 6), cannabis use (n = 5), physical activity (n = 2), smoking (n = 20), stress (n = 3) and nutrition (n = 13). Outcomes included fecundability, IVF/ISCI live birth, offspring weight, body composition/BMI, asthma, lung function, leukemia, preterm birth, and behavioural issues. Despite the limited number of studies and substantial heterogeneity in reporting, results of studies assessed as good quality showed that paternal smoking may increase the risk of birth defects and higher paternal BMI was associated with higher offspring birthweight. Conclusion: The current evidence demonstrates a role of paternal preconception health in influencing outcomes related to pregnancy success and offspring health. The evidence is however limited and heterogenous, and further high-quality research is needed to inform clinical preconception care guidelines to support men and couples to prepare for a health pregnancy and child.
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s12889-023-15335-1
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Accepted/In Press date: 28 February 2023
Published date: 16 March 2023
Additional Information:
Funding Information:
TC is funded under a Commonwealth Government research training stipend (RTP stipend). DS is supported by the National Institute for Health and Social Care Research (NIHR) Southampton Biomedical Research Centre [IS-BRC-1215–20004]). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2023, The Author(s).
Keywords:
Modifiable, Offspring outcomes, Paternal, Preconception, Pregnancy outcomes, Risk factor, Premature Birth, Humans, Risk Factors, Live Birth, Male, Pregnancy, Birth Weight, Female, Fathers, Child, Infant, Newborn, Preconception Care
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Local EPrints ID: 476902
URI: http://eprints.soton.ac.uk/id/eprint/476902
ISSN: 1471-2458
PURE UUID: 23a5f5c8-8d6e-4fd5-96f7-e8a56b96dc13
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Date deposited: 19 May 2023 16:32
Last modified: 18 Mar 2024 03:57
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Author:
Tristan Carter
Author:
Jon Adams
Author:
Amie Steel
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