Association of preconception paternal health on perinatal outcomes: analysis of U.S. claims data

Kasman, Alex M.; Zhang, Chiyuan A.; Li, Shufeng; Stevenson, David K.; Shaw, Gary M.

doi:10.1016/j.fertnstert.2019.12.026

Cited by 32 publications

(32 citation statements)

References 36 publications

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“…Prior studies have shown a clear link between DNA damage and pregnancy outcomes, which could plausibly extend to the perinatal period. As noted by Kasman et al (2), there is also substantial evidence to support a role for epigenetics in transmission of paternal exposures and comorbidity to offspring. Epigenetic changes in sperm through DNA methylation and histone modification in the setting of comorbidity, dietary changes, paternal age, and even psychological stress are transmissible to the offspring (5).…”

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confidence: 86%

“…The most recent work from Kasman et al (2) demonstrates that the effects of paternal health extend well-beyond semen parameters, fertilization, and even pregnancy, into the perinatal period. Using a large commercial healthcare claims database, these investigators found that paternal comorbidity was a risk factor for adverse perinatal outcomes such as preterm birth, low birth weight, and neonatal intensive care unit admission, even when controlling for maternal age and maternal morbidity.…”

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confidence: 99%

“…Second, due to constraints of the data source, the study did not account for potential confounders that could impact perinatal outcomes. Kasman et al (2) appropriately acknowledge unmeasured confounders, such as sociodemographic factors, care access, diet, environmental exposures, and use of fertility treatments, that could impact the results. These unmeasured confounders are particularly critical given the low effect size, which could be quite sensitive to these covariates.…”

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confidence: 99%

“…Beyond the clear role for male partner evaluation in the context of subfertility, the current data indicate a possible role for increased preconception male evaluation. Kasman et al (2) should be commended for their thought-provoking and hypothesis-generating work. Further research efforts are needed not only to elucidate the mechanisms by which paternal health may influence birth and maternal outcomes, but also to determine whether clinical intervention to screen for and improve paternal comorbidity can meaningfully impact these outcomes in a positive way.…”

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confidence: 99%

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Paternal health and perinatal morbidity: increasing evidence for the influence of paternity on fertility outcomes

Halpern

Brannigan

2020

Fertility and Sterility

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confidence: 86%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Paternal health and perinatal morbidity: increasing evidence for the influence of paternity on fertility outcomes

Halpern

Brannigan

2020

Fertility and Sterility

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“…While the influence of the mother on birth outcomes is well known, less is understood about paternal factors that may influence pregnancy. Recently, a variety of paternal factors, such as age and health, have been shown to found to be associated with neonatal outcomes in children 1,2 . Additionally, paternal lifestyle and environmental effects could affect offspring via epigenetic changes in spermatozoa influencing offspring phenotype 3,4 .…”

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confidence: 99%

Relationship between male age, semen parameters and assisted reproductive technology outcomes

Kasman

Zhao

et al. 2020

Andrology

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Background Low semen quality often obligates the use of assisted reproductive technology; however, the association between semen quality and assisted reproductive technology outcomes is uncertain. Objectives To further assess the impact of semen quality on assisted reproductive technology outcomes. Materials and Methods A retrospective cohort study was carried out at a single academic reproductive medicine center (January 2012‐December 2018). Patients undergoing at least one assisted reproductive technology cycle utilizing freshly ejaculated spermatozoa from the male partner were included. We assessed the association between semen quality (as stratified based on WHO 5th edition criteria), paternal age (< or ≥40), and reproductive/perinatal outcomes. To evaluate the differences in assisted reproductive technology outcomes by semen parameters and age, generalized estimating equations were applied for rates of fertilization, pregnancy, implantation, miscarriage, live birth, blast formation, gestational age, and normal embryo biopsy. Results A total of 2063 couples were identified who underwent 4517 assisted reproductive technology cycles. Average ages of the male and female partners were 39.8 and 37.7, respectively. Lower pregnancy rates were observed in cycles with lower sperm motility (ie <40%; 39.9% vs 44.1%) and total motile count (ie <9 million; 38.3% vs 43.5%). When examining only cycles utilizing Intracytoplasmic Sperm Injection, only a lower motility count was associated with a decline in pregnancy rate (39.1% vs 44.9%). No association was identified between semen quality and gestational age or birth weight. Paternal age was not associated with ART outcomes. However, among assisted reproductive technology cycles in women <40, aneuploidy rate was higher for older men (P < .001). In cycles with women >40, no association between aneuploidy and male age was identified. Discussion Sperm motility is associated with pregnancy rates, while other semen parameters are not. In cycles in women <40, paternal age is associated with embryo aneuploidy rate. Conclusion Paternal factors are associated with assisted reproductive technology outcomes, and future studies should explore mechanisms by which semen quality is associated with assisted reproductive technology outcomes.

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Preconception paternal comorbidities and offspring birth defects: Analysis of a large national data set

Zhang

et al. 2022

Birth Defects Research

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Background Despite the fact that the father contributes half the genome to a child, associations between paternal factors and birth defects are poorly understood. Objectives To investigate the association between preconception paternal health and birth defects in the offspring. Materials and Methods We conducted analysis of a national cohort study utilizing the IBM Marketscan Research Database, which includes data on reimbursed private healthcare claims in the United States from 2007 to 2016. The potential association between paternal comorbidities, as measured by the components of metabolic syndrome (MetS), and any birth defect in the offspring was analyzed. Results Of the 712,774 live births identified, 21.2% of children were born to fathers with at least one component of the metabolic syndrome (MetS ≥1) prior to conception. Compared to infants born to fathers with no components of the metabolic syndrome, a modestly higher percentage of infants with cardiac birth defects were born to fathers with more components of MetS (MetS = 1, OR [95% CI]: 1.07 [1.01–1.13]; MetS ≥2, 1.17 [1.08–1.26], in comparison to MetS = 0) after adjusting for maternal and paternal factors. Similarly, a higher percentage of infants with respiratory defects were born to fathers with two or more components of metabolic syndrome (MetS ≥2, OR [95% CI]: 1.45 [1.22–1.71]). Discussion and Conclusion In this private insurance claims‐based study, we found that fathers with metabolic syndrome‐related diseases before conception were at increased risk for having a child affected by birth defects, especially cardiac and respiratory defects, and this association was not influenced by paternal age or assessed maternal factors.

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Association of preconception paternal health on perinatal outcomes: analysis of U.S. claims data

Cited by 32 publications

References 36 publications

Paternal health and perinatal morbidity: increasing evidence for the influence of paternity on fertility outcomes

Paternal health and perinatal morbidity: increasing evidence for the influence of paternity on fertility outcomes

Relationship between male age, semen parameters and assisted reproductive technology outcomes

Preconception paternal comorbidities and offspring birth defects: Analysis of a large national data set

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