Preparing for a healthy pregnancy has traditionally been seen as a woman’s responsibility – with expectant mothers urged to stop drinking alcohol, avoid certain foods and overhaul their lifestyle to give their baby the best possible start in life.
But scientists now say the father’s health before conception may also play a crucial role in shaping a child’s development.
A major new review published in The Lancet warns that factors such as a man’s smoking, alcohol use, weight, mental health and diet before conception can influence pregnancy outcomes and the long-term health of their children.
The researchers write that ‘men are important contributors to the health of future generations’, yet their own preconception health ‘remains a secondary consideration in research, practice, and policy.’
Research cited in the paper suggests paternal drinking before conception is linked to a higher risk of birth defects, while smoking and other lifestyle factors may alter sperm in ways that influence foetal development.
Allan Pacey, Professor of Andrology at the University of Manchester, told the Daily Mail that the importance of the male role in pre-conception ‘still comes as a surprise to many’ and needs to be taken more seriously.
The authors say their research challenges the long-standing tendency for studies and public health policy to focus almost exclusively on mothers.
They argue that ‘greater attention to the life course health and wellbeing of boys and young men’ could help improve pregnancy outcomes and child health across generations.
Scientists now say fathers’ health before conception may also play a crucial role in shaping a child’s development.
The review comes amid growing concern about male reproductive health.
Previous research cited in the paper found global sperm counts have fallen by more than 50 per cent between 1973 and 2018. However, the scientists say sperm quantity is only part of the picture.
Evidence suggests sperm quality can also be shaped by a wide range of factors across a man’s life, including diet, obesity, exercise, environmental exposures and psychological stress.
These factors may alter sperm in ways that can affect fertility, pregnancy outcomes and the health of children.
Prof Pacey said: ‘We’ve known for a long time that aspects of a father’s health and lifestyle can impact on the health and wellbeing of any children born, yet this has failed to gain much traction in healthcare policy and in society as a whole.
‘It still comes as a surprise to many people, and I know when I have been asked to speak about male pre-conception health at conferences, it has often been as a side show to the main event and to a smaller audience of people who are already on board.
‘It was noteworthy that in the Men’s Health Strategy for England published last year that men’s role in reproduction was barely mentioned. If we are to improve the situation for men, women and children we need to start taking male reproductive health seriously.’
The researchers also highlight the role fathers play in supporting their partner’s health during pregnancy.
Studies show that when fathers are actively involved and supportive, mothers are more likely to attend antenatal care, avoid alcohol and smoking and adopt healthier behaviours.
Supportive partners are also linked to lower levels of depression and anxiety in pregnant women.
By contrast, the review notes that fathers’ own mental health problems can affect family wellbeing.
Research cited in the paper found that children of fathers with depression or significant depressive symptoms were more likely to develop depression themselves.
Men who had experienced depression or anxiety earlier in life were also more likely to report psychological distress during their partner’s pregnancy.
Many of these problems are linked to what researchers describe as ‘adverse childhood experiences’, including poverty, neglect and trauma during childhood.
Such experiences can have lasting effects on mental health and behaviour, which may influence how well men are able to support their partners and participate in parenting.
The authors say focusing only on mothers risks unfairly placing responsibility for a child’s future health on women. They warn that this can leave mothers as ‘the sole bearers of responsibility for offspring outcomes.’
The researchers concluded that greater attention should be paid to men’s health long before they become fathers.
This could include education about preconception health, better access to healthcare for men and wider efforts to address mental health and social inequalities.
They write: ‘Although most men do not receive preconception education and care, the case to do so grows more urgent: male obesity, smoking, mental illness and medications that impair male reproductive health are common from a young age.’
The authors conclude that improving the health and wellbeing of boys and young men could play an important role in improving pregnancy outcomes, child development and family health across generations.