title: Investigating paternal preconception risk factors for adverse pregnancy outcomes in a population of internet users.
abstract: BACKGROUND
  Paternal preconception risk factors such as smoking, exposure to environmental substances, medication use, overweight and advanced age correlate with the occurrence of malformations and birth defects in the offspring. Nonetheless, the prevalence of risk factors for adverse pregnancy outcomes in the male population has been scarcely investigated and no report on preconception interventions targeting prospective fathers is available. We conducted a web-based survey to measure the prevalence of paternal preconception risk factors for adverse pregnancy outcomes in an Italian population of Internet users.
  
  
  METHODS
  Prospective or expectant fathers were enrolled during a four-week period through two of the main Italian web-sites dedicated to preconception, pregnancy, childhood and family care. Participants filled in a web questionnaire regarding preconception risk factors for adverse pregnancy outcomes. Logistic regression analysis was used to explore the predictors of paternal preconception risk factors.
  
  
  RESULTS
  We enrolled 131 prospective and 205 expectant fathers. More than half of the total participants used medications during the preconception period, 35% were smokers and 8% were obese. Exposure to environmental substances was declared by almost 20% of the participants, with the group including pesticides/herbicides/professional paints being the most prevalent. More than a half of the study sample included men aged over 35 years. According to the multivariate analysis, smoking and exposure to environmental toxics were less frequent among individuals with a university degree (respectively: OR = 0.52; 95% CI 0.32-0.84; OR = 0.52; 95% CI 0.29-0.93). Paternal obesity and medication use in the preconception period were not associated with any of the independent variables.
  
  
  CONCLUSIONS
  The prevalence of preconception risk factors among male population should not be neglected when planning preconception interventions, confirming that preconception health must be focused on the couple, rather than on women only.
authors.affiliation: Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy. eleonora.agricola@gmail.com.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Agricola
authors.affiliation: Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Gesualdo
authors.affiliation: Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Carloni
authors.affiliation: Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: D'Ambrosio
authors.affiliation: Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Russo
authors.affiliation: Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Campagna
authors.affiliation: Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pandolfi
authors.affiliation: Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
authors.forename: Alberto E
authors.initials: AE
authors.lastname: Tozzi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004522:Educational Status; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D020407:Internet; D007558:Italy / Q000453:epidemiology; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects; D010150:Paint / Q000633:toxicity*; D010331:Paternal Age; D010332:Paternal Behavior; D018812:Paternal Exposure / Q000009:adverse effects*; D010575:Pesticides / Q000633:toxicity*; D047489:Preconception Injuries / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
chemical_list: D010575:Pesticides
keywords: Adverse pregnancy outcomes; Maternal and child health; Men Health; Paternal health; Preconception care; Preconception health; Preconception men