More equitable preconception health: paternal life course opportunities for better pregnancy, child, and family outcomes.

Abstract

Men and partners are important contributors to the health of future generations, yet their own preconception health and wellbeing remain secondary considerations in research, practice, and policy. Siloed research has exacerbated this deficit. Clinical research typically has a narrow focus on proximal behavioural factors related to periconceptional events (eg, paternal dietary influences on the sperm epigenome), with social research focusing largely on postnatal parenting. Here, we update and reappraise the evidence for men's role in preconception health through a transdisciplinary review. Across biological and behavioural research, young men's early life course experiences have been shown to shape their own and their partner's preconception physical, emotional, and behavioural health. Moreover, focusing on men's preconception health offers a corrective for legacies of sexism, which place responsibility for intergenerational health solely on the birthing parent, and of racism and colonialism, which have disproportionately disrupted the familial and societal roles of Black and Brown men. We provide three case studies illustrating these ethical concerns and conclude that greater attention to young men would lead to more equitable and holistic preconception health interventions and policy.