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Dehghanbanadaki H, Jimbo M, Fendereski K, Kunisaki J, Horns JJ, Ramsay JM, Gross KX, Pastuszak AW, Hotaling JM. Transgenerational effects of paternal exposures: the role of germline de novo mutations. Andrology 2025; 13:101-118. [PMID: 38396220 DOI: 10.1111/andr.13609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/02/2023] [Accepted: 01/23/2024] [Indexed: 02/25/2024]
Abstract
Germline de novo mutations (DNMs) refer to spontaneous mutations arising during gametogenesis, resulting in genetic changes within germ cells that are subsequently transmitted to the next generation. While the impact of maternal exposures on germline DNMs has been extensively studied, more recent studies have begun to highlight the increasing importance of the effects of paternal factors. In this review, we have summarized the existing literature on how various exposures experienced by fathers affect the germline DNM burden in their spermatozoa, as well as their consequences for semen analysis parameters, pregnancy outcomes, and offspring health. A growing body of literature supports the conclusion that advanced paternal age (APA) correlates with a higher germline DNM rate in offspring. Furthermore, lifestyle choices, environmental toxins, assisted reproductive techniques (ART), and chemotherapy are associated with the accumulation of paternal DNMs in spermatozoa, with deleterious consequences for pregnancy outcomes and offspring health. Ultimately, our review highlights the clear importance of the germline DNM mode of inheritance, and the current understanding of how this is affected by various paternal factors. In addition, we explore conflicting reports or gaps of knowledge that should be addressed in future research.
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Affiliation(s)
- Hojat Dehghanbanadaki
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Masaya Jimbo
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Kiarad Fendereski
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Jason Kunisaki
- Department of Human Genetics, University of Utah, Salt Lake City, Utah, USA
| | - Joshua J Horns
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Joemy M Ramsay
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Kelli X Gross
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - Alexander W Pastuszak
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah, USA
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Abulhamail A, Abulhamail R. Determinants of childbearing intentions among pregnant women with a suspected fetal congenital heart disease. Midwifery 2024; 128:103875. [PMID: 37979551 DOI: 10.1016/j.midw.2023.103875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND The Saudi population is characterized by a high fertility rate, a conservative sociocultural context, and an ongoing societal and lifestyle transition. Yet, data regarding childbearing intentions and the associated factors is scarce. Furthermore, childbearing intention may be impacted by abnormal pregnancy events, such as the clinical suspicion or diagnosis of a fetal congenital disease and the negative experience that may result from it. OBJECTIVES The present study explored childbearing intention and determined the sociodemographic and health-related factors discouraging from future pregnancies among women visiting the cardiology clinic for antenatal screening of congenital heart diseases (CHD). METHODS A one-year cross-sectional study involved 150 consecutive pregnant women aged between 18 and 47 years old, who presented for antenatal screening of CHD at the fetal echocardiography clinic for, of a teaching hospital in Jeddah, Saudi Arabia. An interview-based questionnaire was administered before the clinic visit and collected sociodemographic data, obstetrical history, risk factors of congenital diseases, mothers' knowledge about fetal echocardiography and CHDs, and childbearing intention (the primary outcome). RESULTS Fetal echocardiography and CHD were correctly described by 60 % and 31.3 % of the participants respectively, while 40.7 % and 12 % recognized the association of congenital diseases with consanguinity and advanced maternal age respectively. Childbearing intentions showed 68.0 % of the participants declared desiring a future baby while the remaining 32.0 % declared having no further pregnancy expectations. Attitudes towards a hypothetical baby with CHD were positive in 97.3 % of the participants, and only 30 % declared that the fetal echocardiography results will impact their future childbearing decision. However, childbearing intention showed no significant association with knowledge or attitudes towards CHD. On the other hand, childbearing intention was independently associated with the number of children (OR=0.34; p<0.001), consanguinity with husband (OR=3.64; p = 0.010), and history of gestational diabetes (OR=0.28; p = 0.040). CONCLUSION Fertility expectations among Saudi mothers are more likely to be impacted by the personal experience and judgment of own pregnancy fitness, while no significant impact of fetal risks and events. This demonstrates a certain level of autonomy balanced with deeply rooted religious ethics yet combined with a lack of awareness about fetal and maternal risks associated with advanced maternal age and consanguinity. We emphasize the unmet need of education and family planning.
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Affiliation(s)
- Albraa Abulhamail
- Pediatric Teaching assistant, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Reham Abulhamail
- Medical student in Ibn Sina medical school, Jeddah, Saudi Arabia
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Cassinelli EH, McClure A, Cairns B, Griffin S, Walton J, McKinley MC, Woodside JV, McGowan L. Exploring Health Behaviours, Attitudes and Beliefs of Women and Men during the Preconception and Interconception Periods: A Cross-Sectional Study of Adults on the Island of Ireland. Nutrients 2023; 15:3832. [PMID: 37686864 PMCID: PMC10490475 DOI: 10.3390/nu15173832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Preconception health is increasingly seen as a key target for improving population health in the UK and Ireland, yet little is known about the attitudes and beliefs of adults regarding preconception care strategies. This online cross-sectional survey aimed to explore the health behaviours, attitudes and beliefs of adults of reproductive age in regard to preconception health and care. The survey was developed by reviewing the previous literature and engaging with those from the target group. It is one of the first surveys to assess the attitudes and beliefs of adults of reproductive age across the Island of Ireland regarding preconception health and care. Results from 386 individuals with a mean age of 29.9 ± 10.3 years were included. A variety of health behaviours, attitudes and beliefs were investigated, with differences being identified between women and men and between participants with or without children (i.e., in the preconception or interconception stage). The majority of respondents held beliefs that preconception care was important, but there was greater emphasis on women than men in terms of the need to engage in health-promoting preconception health behaviours. This study highlights the need to improve preconception health awareness in women and men in the preconception and interconception stage. Findings indicate that efforts to improve preparation for pregnancy among adults of childbearing age are needed, to ensure optimal engagement in preconception health behaviours, with efforts being tailored based on sex and parental status.
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Affiliation(s)
- Emma H. Cassinelli
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK
| | - Abby McClure
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Ben Cairns
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Sally Griffin
- Department of Biological Sciences, Munster Technological University, T12 P928 Cork, Ireland
| | - Janette Walton
- Department of Biological Sciences, Munster Technological University, T12 P928 Cork, Ireland
| | - Michelle C. McKinley
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK
| | - Jayne V. Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK
| | - Laura McGowan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK
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Cinelli G, Croci I, Gesualdo F, Pandolfi E, Miller KP, Tozzi AE. Public Engagement in Digital Recommendations for Promoting Healthy Parental Behaviours from Preconception through the First 1000 Days. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1329. [PMID: 36674084 PMCID: PMC9859030 DOI: 10.3390/ijerph20021329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/30/2022] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
Web-based digital interventions may play a central role for health promoting strategies in the first "1000 days", from conception through the first 2 years of life. We developed a web platform providing evidence-based recommendations in the first 1000 days through short videos, and we studied engagement by users from preconception through parenthood in the second year of life. We described the access to videos by topic and used a multilevel model to explore the user characteristics associated with access to the video recommendations. Overall, breastfeeding, physical activity and nutrition were the most popular topics (normalized views: 89.2%, 87.2% and 86.4% respectively), while content on paternal health and smoking and alcohol was less engaging (37.3% and 42.0%). Nutrition content was the most viewed in the preconception period and during the first two trimesters of pregnancy. Nutrition and breastfeeding were also the most popular topics for users with children less than 2 years old. Higher levels of health literacy were associated only with child health content. The study findings indicate that digital strategies should be adapted according to the time period in the first 1000 days. Alternative digital promotion strategies for the less engaging topics should be considered.
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Affiliation(s)
| | - Ileana Croci
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
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Agrawal J, Chakole S, Sachdev C. The Role of Fathers in Promoting Exclusive Breastfeeding. Cureus 2022; 14:e30363. [PMID: 36407167 PMCID: PMC9665906 DOI: 10.7759/cureus.30363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023] Open
Abstract
The cornerstone of a newborn's nutrition is breastfeeding. Due to its well-known benefits for mothers, children, and society in the short and long term, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) recommend it as the best way of feeding the baby during the first six months of life. The family, particularly the spouse, may significantly influence the baby's quality of nursing. On a global scale, previous studies have demonstrated that family members (such as a mother's spouse, partner, or grandmother) not only affect her choice to start and endure breastfeeding but also significantly contribute to the early postnatal period's cessation of appropriate breastfeeding. A father's knowledge and attitude are fundamental in this regard, as he has the most critical role in helping women with parenting and feeding their babies. Furthermore, because the father's role is considered important in a family, the partner's or wife's perception of the father's attitude may alter her subjective criteria about exclusive breastfeeding (EBF). Future initiatives should target new mothers and their spouses to see how they may provide the most beneficial assistance to new mothers. The main focus should be on targeting newly married couples. The father's lack of involvement may be due to the hierarchical structure of power within households. Because of this hierarchical aspect, partners or fathers may significantly influence a mother's choice to nurse their child correctly. Household chores, childcare for grown-up children, guaranteeing the well-being of their spouse, preparing meals, recognizing a newborn's hunger cues, burping, and changing the infant's diaper after feedings, all these factors indirectly support the mother in initiating and enduring the nursing of a child.
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Affiliation(s)
- Jayesh Agrawal
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Chetna Sachdev
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Paternal Diet before Conception and Its Social Determinants in the Elfe Cohort. Nutrients 2022; 14:nu14194008. [PMID: 36235660 PMCID: PMC9570592 DOI: 10.3390/nu14194008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to characterize paternal diet during the peri-conception period and its associated characteristics. These cross-sectional analyses were based on 998 fathers from the French nationwide ELFE birth cohort recruited in 2011. Fathers’ diet before mothers’ pregnancies was assessed by a 46-item food frequency questionnaire. Six exploratory dietary patterns were identified by principal component analysis: “Diverse diet”, “Balanced”, “Alcohol”, “Snacking”, “Bread and cheese”, and “Processed products”. Older age was related to higher scores for the “Balanced”, “Alcohol”, and “Snacking” patterns, and high education level with high scores on the “Balanced” pattern and low scores on the “Processed products” pattern. Unemployment and having a first child were related to high scores on the “Alcohol” pattern. Smoking was positively related to “Alcohol” and “Processed products” patterns. A restrictive diet was associated with high scores on the “Balanced” and “Processed products” patterns and low scores on “Alcohol”, “Snacking”, and “Bread and cheese” patterns. Maternal dietary patterns, identified in a previous analysis, were moderately and positively related to the similar patterns among fathers. These findings are important for screening fathers at risk of a suboptimal diet and for accounting for this factor in future studies to examine the specific influence of paternal diet on a child’s health and development.
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Maas VYF, Poels M, Stam AL, Lieftink N, Franx A, Koster MPH. Exploring male perceptions regarding the need to engage in preconception care - a mixed-method study amongst Dutch (prospective) fathers. EUR J CONTRACEP REPR 2022; 27:322-329. [PMID: 35297717 DOI: 10.1080/13625187.2022.2045933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE While most preconception care (PCC) interventions are aimed at women, men are also in need of PCC to reduce risk factors affecting the spermatozoa quality. The objective of this study is to explore male perceptions regarding the need to engage in PCC. MATERIALS AND METHODS In a mixed-method cross-sectional study, 229 men participated with a questionnaire and 14 individual semi-structured interviews were conducted. Questionnaires data were analysed using multiple regression analyses. The interviews were analysed using thematic analyses. RESULTS Most men did not retrieve preconceptional information (n = 135; 59.0%) nor visited a preconceptional consult (n = 182; 79.5%). Men who categorised their preconceptional lifestyle as unhealthy (score ≤6 out of 10) less often retrieved information (adjusted OR 0.36 [95% CI 0.14-0.93]) than men with a healthy preconceptional lifestyle. While several men expressed their fear for infertility, this did not lead to an increased uptake of PCC as men felt they were healthy enough already. CONCLUSION Despite high awareness of the positive influence of a healthy lifestyle, the perceived need for preparing for pregnancy among men remains low. Tailoring preconceptional information towards male needs provides a window of opportunity to improve men's reproductive health and possibly the health of future generations.
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Affiliation(s)
- Veronique Y F Maas
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Marjolein Poels
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Research Agency Care2Research, Amsterdam, The Netherlands
| | - Angela L Stam
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Natalie Lieftink
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Arie Franx
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Maria P H Koster
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Laforest ME, Ward S, Landry LA, Mobetty F. The Relationship Between Paternal Preconception Obesity and Health Behaviors and Childhood Obesity: Protocol for a Systematic Review. JMIR Res Protoc 2021; 10:e31254. [PMID: 34860672 PMCID: PMC8686461 DOI: 10.2196/31254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background Childhood obesity is a global public health concern and is a priority for researchers and policy makers. To overcome the epidemic of obesity, influencing factors throughout the life span need to be addressed, including those in the preconception period. A better understanding of the association between paternal preconception factors and childhood obesity is important for public health interventions. Objective This systematic review will examine the relationship between paternal preconception obesity and health behaviors and their offspring’s overweight or obesity. Methods Peer-reviewed quantitative studies and grey literature that report associations between paternal preconception obesity and health behaviors—such as smoking, exercise, and eating habits—and childhood overweight and obesity will be identified through a computerized literature search in 7 databases. The quality of each study will be assessed using the Quality Assessment Tool for Quantitative Studies. Characteristics of the included studies will be reported, and relevant findings from each paternal preconception exposure will be narratively synthesized. This review will follow the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 guidelines. Results This systematic review is anticipated to begin in December 2021 and be completed by the end of August 2022. Conclusions This systematic review will contribute to a better understanding of the relationship between preconception paternal exposures and their offspring’s overweight or obesity. Findings will help support health professionals working with prospective parents to educate fathers on the benefits of improving their weight and health behaviors during the preconception period. International Registered Report Identifier (IRRID) PRR1-10.2196/31254
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Affiliation(s)
- Marie-Eve Laforest
- École de Science Infirmière, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB, Canada
| | - Stephanie Ward
- École des Sciences des Aliments, de Nutrition et d'Etudes Familiales, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB, Canada
| | - Liette-Andrée Landry
- École de Science Infirmière, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Campus de Shippagan, Shippagan, NB, Canada
| | - Fabrice Mobetty
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
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Wensink MJ, Rizzi S, Jensen TK, Skakkebaek NE, Lu Y, Lindahl-Jacobsen R, Eisenberg ML. Paternal prescription medication before conception: A retrospective cohort study of all births in Denmark 1997-2017. Scand J Public Health 2021; 49:884-890. [PMID: 33615897 DOI: 10.1177/1403494820987468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AIM To study what medication fathers are being prescribed in the months preceding conception. METHODS A retrospective cohort study of Danish national registries, comprising all births in Denmark 1997-2017 (1.3 million births). Time trends and absolute levels of paternal prescription medication in the 6 months prior to conception were assessed. While all medications were examined (N = 1335), we focused on the main medication groups, medications that have increased in use over time, and medications for which previous evidence exists of an effect on sperm quality. RESULTS The average number of prescriptions increased over the study period (from 0.75 prescriptions to 0.82 per birth). Polypharmacy (three or more prescriptions) increased from less than 8% to 10% of fathers. The use of pain medication, proton-pump inhibitors, selective serotonin reuptake inhibitors and some inhalants have all increased markedly over the last 20 years. CONCLUSIONS Potential harm to the offspring done by paternal medication may present an increasing problem. As paternal medication exposure is increasing, examination of generational effects, such as major birth defects, is necessary.
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Affiliation(s)
- M J Wensink
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense C, Denmark.,Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense C, Denmark
| | - S Rizzi
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense C, Denmark.,Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense C, Denmark
| | - T K Jensen
- Department of Environmental Medicine, University of Southern Denmark, Odense C, Denmark
| | - N E Skakkebaek
- Juliane Marie Centre, Department of Growth and Reproduction, Copenhagen University Hospital, Denmark
| | - Y Lu
- Department of Biomedical Data Science, Stanford University School of Medicine, USA
| | - R Lindahl-Jacobsen
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense C, Denmark.,Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense C, Denmark
| | - M L Eisenberg
- Male Reproductive Medicine and Surgery, Department of Urology, Stanford University School of Medicine, USA
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Couture V, Delisle S, Mercier A, Pennings G. The other face of advanced paternal age: a scoping review of its terminological, social, public health, psychological, ethical and regulatory aspects. Hum Reprod Update 2021; 27:305-323. [PMID: 33201989 DOI: 10.1093/humupd/dmaa046] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a global tendency for parents to conceive children later in life. The maternal dimension of the postponement transition has been thoroughly studied, but interest in the paternal side is more recent. For the moment, most literature reviews on the topic have focused on the consequences of advanced paternal age (APA) on fertility, pregnancy and the health of the child. OBJECTIVE AND RATIONALE The present review seeks to move the focus away from the biological and medical dimensions of APA and synthesise the knowledge of the other face of APA. SEARCH METHODS We used the scoping review methodology. Searches of interdisciplinary articles databases were performed with keywords pertaining to APA and its dimensions outside of biology and medicine. We included scientific articles, original research, essays, commentaries and editorials in the sample. The final sample of 177 documents was analysed with qualitative thematic analysis. OUTCOMES We identified six themes highlighting the interdisciplinary nature of APA research. The 'terminological aspects' highlight the lack of consensus on the definition of APA and the strategies developed to offer alternatives. The 'social aspects' focus on the postponement transition towards reproducing later in life and its cultural dimensions. The 'public health aspects' refer to attempts to analyse APA as a problem with wider health and economic implications. The 'psychological aspects' focus on the consequences of APA and older fatherhood on psychological characteristics of the child. The 'ethical aspects' reflect on issues of APA emerging at the intersection of parental autonomy, children's welfare and social responsibility. The 'regulatory aspects' group different suggestions to collectively approach the implications of APA. Our results show that the field of APA is still in the making and that evidence is lacking to fully address the issues of APA. The review suggests promising avenues of research such as introducing the voice of fathers of advanced age into the research agenda. WIDER IMPLICATIONS The results of this review will be useful for developing policies and preconception health interventions that consider and include prospective fathers of advanced age.
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Affiliation(s)
- Vincent Couture
- Faculty of Nursing, Université Laval, Québec G1V 0A6, Canada
- Research Center of the CHU de Québec-Université Laval, Québec G1L 3L5, Canada
| | - Stéphane Delisle
- Research Center of the CHU de Québec-Université Laval, Québec G1L 3L5, Canada
| | - Alexis Mercier
- Faculty of Nursing, Université Laval, Québec G1V 0A6, Canada
| | - Guido Pennings
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Gent 9000, Belgium
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Hill B, Hall J, Skouteris H, Currie S. Defining preconception: exploring the concept of a preconception population. BMC Pregnancy Childbirth 2020; 20:280. [PMID: 32381056 PMCID: PMC7206804 DOI: 10.1186/s12884-020-02973-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 04/28/2020] [Indexed: 11/15/2022] Open
Abstract
Background Health prior to conception can significantly impact offspring health, however, a clear definition of the attributes of the preconception population is currently lacking. We aimed to use existing literature to explore the concept and attributes of a preconception population by: [1] identifying characteristics and research recruitment methods; and [2] generating an attribute-based working definition of a preconception population. Methods A rapid review of current literature using CINAHL and the subject heading ‘pre-pregnancy care’ was conducted (Stage 1). Data extracted included definitions of preconception, participant inclusion/exclusion criteria, participant characteristics, and recruitment methods. Stage 2 involved a wider search of relevant publications beyond peer-reviewed literature followed by a concept analysis of the phrase “preconception population” applying Walker and Avant’s framework (Stage 2). Results Twenty-three papers (19 studies) were included in Stage 1. “Preconception” was explicitly defined in one study. Twelve studies specified participants must be planning a pregnancy. Stage 2 included 33 publications. Four key perspectives for the concept of the preconception population were derived: [1] intentional; [2] potential; [3] public health; and [4] life course. Conclusions Adopting these perspectives may allow researchers to accurately define, identify and recruit preconception populations and to develop interventions that are appropriately broad or tailored depending on population needs. We hope the definitions will facilitate research with this population and will subsequently improve the wellbeing of preconception men and women, which is essential to ensuring the health of future generations.
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Affiliation(s)
- Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia.
| | - Jennifer Hall
- EGA Institute for Women's Health, University College London, 74 Huntley St, London, WC1E 6AU, UK
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia
| | - Sinéad Currie
- Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, FK9 4LA, UK.
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Shawe J, Patel D, Joy M, Howden B, Barrett G, Stephenson J. Preparation for fatherhood: A survey of men's preconception health knowledge and behaviour in England. PLoS One 2019; 14:e0213897. [PMID: 30893380 PMCID: PMC6426231 DOI: 10.1371/journal.pone.0213897] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/03/2019] [Indexed: 12/26/2022] Open
Abstract
METHODS A cross-sectional survey of men attending antenatal care with their partners at three London Maternity Units. We assessed level of pregnancy planning using the partner version of the London Measure of Unplanned Pregnancy (LMUP), preconception health behaviours, and whether they had sought information and health professional advice before conception. MAIN RESULTS We recruited 573 men (91% response rate). Mean age was 34 years, 86% were in employment or full time education and 66% had a degree. Half were overweight or obese, 16% were still smoking and 79% had consumed alcohol in the three months before conception. Of 250 men answering questions about medication, a third were taking medication with potentially adverse effects on male reproductive health, while 23% reported taking pre-pregnancy vitamins. 46.9% had looked at information about pregnancy from a variety of sources, including online, before their partner became pregnant. Assessed by the LMUP, 74% of pregnancies were planned. Male 'planners' were more likely than other men to reduce smoking, reduce alcohol consumption and to eat more healthily in preparation for pregnancy. However, 57% took no action to improve their health. SIGNIFICANCE OF THE FINDINGS In a sample of relatively educated men accompanying their partners on an antenatal visit, nearly half had made at least one positive health behaviour change before pregnancy, but half were overweight or obese and a third were on medication that could impair male reproductive health. These findings, together with a high prevalence of alcohol consumption and smoking, indicate the need for greater paternal preconception health awareness and care. Innovative ways to promote positive messages about fatherhood, including medication review as part of preconception care, should be evaluated for impact on improving paternal reproductive health and pregnancy and neonatal outcomes.
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Affiliation(s)
- Jill Shawe
- Institute of Health & Community University of Plymouth, Plymouth, United Kingdom
- Institute for Women’s Health, University College London, London, United Kingdom
| | - Dilisha Patel
- Institute for Women’s Health, University College London, London, United Kingdom
| | - Mark Joy
- School of Health Sciences University of Surrey, Guildford, United Kingdom
| | - Beth Howden
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Geraldine Barrett
- Institute for Women’s Health, University College London, London, United Kingdom
| | - Judith Stephenson
- Institute for Women’s Health, University College London, London, United Kingdom
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13
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Kothari A, Thayalan K, Dulhunty J, Callaway L. The forgotten father in obstetric medicine. Obstet Med 2019; 12:57-65. [PMID: 31217809 DOI: 10.1177/1753495x18823479] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 01/20/2023] Open
Abstract
The role of fathers prior to conception, during pregnancy, and in the post-partum period has generally not been a key consideration for Obstetric Physicians. However, this view may need challenging. This paper outlines the key importance of fathers in all phases of obstetric medical care. We review the contribution of paternal factors such as genetics, health, and lifestyle to fetal development, pregnancy complications, and maternal and neonatal wellbeing. The role of fathers in complex care decisions during pregnancy is also reviewed. Postpartum, fathers have a substantial role in shaping the future of the family unit through encouraging breastfeeding and creating a supportive environment for motherhood. This review proposes areas for future research and recommends an evidence-based change in practice in obstetric medicine that focuses on recognizing the role of fathers in the pregnancy journey.
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Affiliation(s)
- A Kothari
- University of Queensland, Brisbane, Australia.,Department of Obstetrics and Gynaecology, Redcliffe Hospital, Brisbane, Australia
| | - K Thayalan
- University of Queensland, Brisbane, Australia.,Department of Obstetrics and Gynaecology, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - J Dulhunty
- University of Queensland, Brisbane, Australia.,Medical Administration, Redcliffe Hospital, Brisbane, Australia
| | - L Callaway
- University of Queensland, Brisbane, Australia.,Department of Obstetric Medicine, The Royal Brisbane and Women's Hospital, Brisbane, Australia
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14
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Sharp GC, Lawlor DA, Richardson SS. It's the mother!: How assumptions about the causal primacy of maternal effects influence research on the developmental origins of health and disease. Soc Sci Med 2018; 213:20-27. [PMID: 30055422 PMCID: PMC6137073 DOI: 10.1016/j.socscimed.2018.07.035] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/17/2018] [Accepted: 07/20/2018] [Indexed: 12/22/2022]
Abstract
Research on the developmental origins of health and disease (DOHaD) has traditionally focused on how maternal exposures around the time of pregnancy might influence offspring health and risk of disease. We acknowledge that for some exposures this is likely to be correct, but argue that the focus on maternal pregnancy effects also reflects implicit and deeply-held assumptions that 1) causal early life exposures are primarily transmitted via maternal traits or exposures, 2) maternal exposures around the time of pregnancy and early infancy are particularly important, and 3) other factors, such as paternal factors and postnatal exposures in later life, have relatively little impact in comparison. These implicit assumptions about the "causal primacy" of maternal pregnancy effects set the agenda for DOHaD research and, through a looping effect, are reinforced rather than tested. We propose practical strategies to redress this imbalance through maintaining a critical perspective about these assumptions.
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Affiliation(s)
- Gemma C Sharp
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol Dental School, University of Bristol, United Kingdom.
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Population Health Science, Bristol Medical School, University of Bristol, United Kingdom
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15
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Use of Thiopurines During Conception and Pregnancy Is Not Associated With Adverse Pregnancy Outcomes or Health of Infants at One Year in a Prospective Study. Clin Gastroenterol Hepatol 2017; 15:1232-1241.e1. [PMID: 28342949 DOI: 10.1016/j.cgh.2017.02.041] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Most data on the safety of thiopurine therapy for inflammatory bowel disease (IBD) during pregnancy come from retrospective studies, which makes it difficult to adjust for confounding factors. We performed a prospective cohort study to determine whether thiopurine use affects pregnancy outcomes or health outcomes of children. METHODS We performed a prospective study of all women who visited the IBD preconception outpatient clinic at our tertiary health center in The Netherlands from December 2008 through May 2016. Patients were counseled before pregnancy and seen bimonthly during pregnancy. We collected and analyzed data on medication use, as well as lifestyle and clinical factors, during conception and pregnancy. Pregnancy outcomes (live birth, spontaneous abortion, elective abortion, and stillbirth), birth outcomes (gestational age, birth weight, and congenital abnormalities), and health outcomes of infants 1 year after birth were compared between women who did and did not use a thiopurine during conception and pregnancy. In addition, health outcomes of infants 1 year after birth were compared with infants born to mothers without IBD from the same geographic region. RESULTS Our study comprised 309 women with confirmed IBD (216 with Crohn's disease, 85 with ulcerative colitis, and 8 with IBD unclassified). During the study period, 311 pregnancies of 232 women resulted in a live birth; a thiopurine was used during 108 pregnancies (35%). After correction for diagnosis, fertility treatment, and disease activity, there was no association between thiopurine use and spontaneous abortions. Birth outcomes were similar between women who did and did not use a thiopurine. Among infants 1 year of age, there were no differences in median growth, number of infections, allergies, adverse reactions to vaccinations, or chronic diseases between those born to women who did and did not use a thiopurine or between women with and without IBD. CONCLUSIONS In this prospective cohort study, we found no association between maternal thiopurine use during pregnancy and increased spontaneous abortions, adverse birth outcomes, or adverse health outcomes of infants 1 year after birth.
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Albrecht J, Nast A. Paternal drug exposure: plenty of confounders, few conclusions. Br J Dermatol 2017; 176:847-848. [DOI: 10.1111/bjd.15213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J. Albrecht
- Division of Dermatology; Department of Medicine; J.H. Stroger Hospital of Cook County; Chicago IL U.S.A
- Department of Dermatology; Rush Medical College; Chicago IL U.S.A
| | - A. Nast
- Division of Evidence-Based Medicine (dEBM); Department of Dermatology; Charité-Universitätsmedizin Berlin; Berlin Germany
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