As soon as a pregnancy test comes back positive, all eyes turn to the mother-to-be: for her health and that of the unborn child, she is advised not to smoke, not to drink alcohol, to avoid certain foods, to stay calm, and not to stress out. But a healthy pregnancy and the wellbeing of future generations don’t begin there, nor do they depend solely on her. The father’s health and life history also have an impact. A multidisciplinary review published this week in The Lancet delves into the effects of the father’s life cycle on pregnancy and the child’s health, showing that medical, behavioral, and psychosocial factors in men can also influence pregnancy and the development of their offspring.
The research challenges the traditional approach to prenatal care, which focuses exclusively on the mother, and advocates for shared responsibility during pregnancy. There are direct biological factors, such as sperm quality, the father’s habits, and age, that can influence the outcome of the pregnancy and the child’s development. There are also sociocultural variables, some more indirect than others, linked to the father’s behavior, his relationship with the pregnant woman, and his parenting style, which act like a domino effect and ultimately impact the well-being of both the pregnant woman and the baby. For example, the authors note that paternal support is associated with greater maternal involvement in prenatal care, lower alcohol and tobacco consumption on her part, fewer cases of low birth weight, and higher rates of breastfeeding.
Sperm health is a key factor in successful conception. The authors note that lifestyle habits can cause epigenetic changes in sperm. This means that body weight, exercise, exposure to environmental toxins, or psychological trauma, for example, cause alterations in DNA that, while not modifying its sequence, lead to changes in its functions that affect sperm health. The authors acknowledge, however, that all this evidence, derived from animal studies, cannot yet be translated into recommendations because it is unknown whether such measures—like dietary changes or reduced sedentary behavior—could reverse epigenetic damage to sperm.
Scientists also emphasize that sperm health is not solely determined by a man’s habits at the time of conception. Although sperm are rapidly and constantly renewed, men carry a lifetime of experiences that can cause lasting epigenetic changes in their reproductive cells and affect their offspring. For example, a Swedish study of over 11,000 men demonstrated that paternal overeating as a child (between the ages of 9 and 12) was associated with a higher risk of diabetes-related mortality in their sons.
“Our findings demonstrate that a man’s childhood experiences, including stress, physical and mental health, environment, and education, influence his health during his reproductive years,” summarizes Danielle Schoenaker, author of the research, in a statement.
The father’s age, a key factor
The father’s age is also key in terms of his offspring’s health outcomes. The authors cite research that concluded that advanced paternal age at conception was associated with a higher risk of stillbirth, birth defects, schizophrenia, and autism spectrum disorder (ASD). Another meta-analysis also found that fatherhood over the age of 45 was associated with a higher risk of ASD.
Researchers go beyond strictly biological factors and examine the role of men within the couple and its impact on maternal health. Along these lines, they point out that pregnant women reported healthier eating habits when their partners actively participated in cooking and shopping, rather than when they offered more passive support, such as giving advice.
And another example of the influence on the partner: women who perceived a more understanding partner had lower levels of perinatal depression and anxiety; in contrast, “avoidant coping styles in partners are associated with higher rates of maternal depression,” experts say. And this is no trivial matter, since the mother’s mental health during pregnancy influences the cognitive and socio-emotional outcomes of her offspring.
Researchers are focusing on an element that can become a vicious cycle with no easy break: the lifelong development of executive functions—the cognitive processes of self-control and behavioral adaptation in stressful situations—is fundamental for a couple to be understanding and affectionate. However, adverse childhood experiences, such as poverty or abuse, can lead to a deficit in these executive functions. This translates into men with less self-control and avoidant coping mechanisms, such as alcohol consumption in response to negative emotions. These behaviors, ultimately, can also influence maternal alcohol consumption and other risky behaviors, and lead to gender-based violence. “Deficits in executive functions can increase tension between partners, exacerbating depressive and anxiety symptoms in pregnant women, and the resulting physical and mental health problems,” the authors point out.
The ripple effect of the male life cycle on maternal and child health is immense. The authors note that adverse childhood experiences contribute to the development of anxiety and depression in adolescence, which “persists into reproductive age and is exacerbated during the transition to fatherhood.” In this regard, a two-decade follow-up study of adult men found that those with symptoms of depression or anxiety in adolescence were five times more likely to report psychological distress during their partner’s pregnancy between the ages of 20 and 29 than those without a history of poor mental health in childhood.
Researcher Manel Esteller, an expert in epigenetics, agrees that the focus on inheritance in offspring has always been on the mother and little on the father, but points out that the impact on the epigenome of some variables explored in this review are “complicated to assess” and the evidence is limited: “What science continues to say is that the mother remains the most determining factor for the baby’s health because the baby is exposed to what she does during pregnancy.”
The scientist, who heads the Cancer Epigenetics group at the Sant Pau Research Institute in Barcelona and was not involved in this research, emphasizes that “the father’s age, for example, matters, as do toxic habits that can modify sperm,” but he is cautious about whether certain life experiences, such as childhood trauma, could generate epigenetic changes that offspring would inherit: “These situations could be reflected in the language of DNA, but it’s very difficult to measure. And then, for this to be transmissible to offspring, these changes have to occur in reproductive cells, and the evidence isn’t strong enough to chemically demonstrate that this happens,” he points out.
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