Expecting Dads' Health Linked to Risk for Pregnancy Loss

Pregnancy loss risk is greater when fathers-to-be had claims related to medical conditions in the year before conception, such as diabetes, obesity, or high blood pressure.

Pregnancy loss was more common for couples when the father had medical comorbidities, reports a new study. The findings of the study are published in the journal Human Reproduction.

More than a quarter of pregnancies might be ectopic or end in miscarriage or stillbirth if the father-to-be is unhealthy and has three or more medical conditions such as obesity, diabetes, high blood pressure, or high cholesterol levels. In a retrospective study of nearly a million pregnancies between 2009 and 2016 in the US, researchers found that if the father was diagnosed with metabolic syndrome, including these medical conditions, there was an increased risk of the mother losing the pregnancy.

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‘The risk of miscarriage, stillbirth, or ectopic pregnancy increased with the amount of paternal illnesses. ’

Compared to men who had none of the metabolic syndrome components, the risk of pregnancy loss increased by 10%, 15%, and 19%, respectively, for men with one, two, or three or more components.

Associate Professor Michael Eisenberg from Stanford University School of Medicine (California, USA), who led the research, said: "It's been known for some time that the health of mothers has an impact on the developing fetus and events at the time of birth. This is the first study to suggest that pregnancies sired by men with increasing numbers of medical conditions are at higher risk of ending in miscarriage, ectopic pregnancy, or stillbirth.

"In the group of men we studied, the risk of losing the pregnancy was 17% in couples where the father had no components of the metabolic syndrome but increased to 21% in couples where the father has one metabolic syndrome component, 23% where he has two, and 27% where he has three or more.

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"While this study cannot prove that poor paternal health is a cause of pregnancy loss, it shows there is an association. The clinical implications of these findings are that pre-conception counseling should not forget the father, as his health may have an important impact on the pregnancy."

The researchers analyzed data from US insurance claims, covering 958,804 pregnancies. As well as metabolic syndrome, they gathered information on other medical conditions such as chronic obstructive pulmonary disease (COPD), depression, and heart disease. They also calculated the burden of chronic disease for all patients, including age and medical history of heart failure, heart attack, diseases of the blood vessels, kidney and liver disease, cancer, stroke, and dementia. They adjusted their calculations to consider other factors that could affect pregnancy, particularly the mother's age, health, weight, and whether or not the father or mother smoked.

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A total of 4.6% of men in the study were aged over 45 years, and 23.3% had at least one component of metabolic syndrome before conception. There were 785,809 live births and 172,995 pregnancies (22%) lost to ectopic pregnancy, miscarriage, or stillbirth during the study.

As expected, pregnancy losses increased with the mother's age and the number of other medical conditions. However, the association between the health of the father and pregnancy loss remained. The risk of losing a pregnancy also increased with the age of the father.

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The mechanisms by which the father's health might affect the risk of pregnancy loss is not known.

Prof Eisenberg said: "We hypothesize that the father's health and lifestyle could adversely affect the genetic make-up and expression in the sperm and that this may alter how well the placenta functions. If the placenta isn't working properly, then this could lead to the pregnancy losses that we observed; for instance, we know already that paternal smoking and diet can affect sperm quality."

Limitations of the study include: potential lack of detail and accurate diagnoses inherent in obtaining information from insurance claims databases; pregnancy losses that did not result in a medical claim, for instance, early miscarriage, were not included in the database, although the frequency of miscarriages, stillbirths and ectopic pregnancies observed in the study were similar to estimates for the general US population; as the findings include only privately insured and employed parents, the findings might not be generalizable to other populations; information on important factors such as sociodemographic status, race and substance abuse, was incomplete.

Prof Eisenberg concluded: "We now need confirmatory studies. Hopefully, paternal health can be more integrated into future studies. Also, investigations that target the possible mechanisms will help to understand better the associations we found."

Source-Eurekalert