Why a man’s health before pregnancy matters for the next generation

When we think about preparing for a healthy pregnancy and baby, most advice focuses on women. Such advice might include good nutrition, taking dietary supplements, avoiding alcohol or smoking and managing their medications and health conditions. But growing evidence shows that men’s health also plays a vitally important role in pregnancy and child development.

In a new review of research on health before pregnancy and parenthood (referred to as “preconception health”), we found that the health and life experiences of boys and men can have important influences on pregnancy outcomes and the wellbeing of future children in several ways.

To understand the role of men’s preconception health, we reviewed studies published from 2000 to 2025 from fields including medicine, biology, psychology and social science. Rather than focusing only on the period just before pregnancy, we looked at research examining how men’s health and experiences throughout their lives – from their own time in the womb through to adolescence and adulthood – can affect families later on.

The research explored factors such as men’s physical health, their health-related behaviour, mental health, environmental exposures and social conditions. This included how fathers influence their partner’s health and the family environment their children grow up in.

This broader perspective shows that men’s influence on pregnancy and child outcomes goes far beyond simply providing half of the baby’s genetic inheritance.

The affect of men’s health

As set out in our review, one important pathway through which a father’s health can affect both pregnancy outcomes and the infant’s health is through sperm health.

Factors such as age, the father’s nutrition, whether he smokes, is overweight or obese, has an unhealthy alcohol intake, experiences stress and his level of exposure to pollution or chemicals can all influence so-called non-coding nucleic acid (RNA) signals carried in sperm. These signals can affect how genes act in the early stages of the baby’s development, which can subsequently impact long-term health outcomes in children.

For example, one study of over 500,000 couples found higher odds of birth defects (including cleft lip, digestive tract anomalies and congenital heart disease) when fathers reported drinking alcohol before pregnancy.

Older father’s age (particularly those who conceived a child after the age of 35) is also linked with both risk of birth complications as well as a child’s likelihood of being diagnosed with autism spectrum disorder. These links are stronger than those seen with a mother’s age.

Research involving millions of fathers and children has additionally shown that depression in fathers is linked with higher risks of depression in their children.

Some research even suggests that experiences earlier in life may play a role. For example, studies have linked nutrition and environmental exposures such as food shortage or abundance during boys’ pre-teen years with health outcomes in the next generation.

But biology is only part of the picture, as described in our review.

Men also influence pregnancy through their relationships with their partners. Supportive partners are consistently linked with healthier pregnancies. Women who feel supported are more likely to attend antenatal appointments, avoid smoking or alcohol, maintain healthier diets and experience lower levels of stress and depression during pregnancy.

These factors matter because a mother’s mental health and wellbeing during pregnancy are closely linked to children’s emotional, cognitive and physical development.

Another pathway is through parenting. A father’s mental health, stress levels and childhood experiences can influence how he interacts with his children after birth.

For example, men who experienced adversity growing up – such as poverty, neglect or trauma – are more likely to experience anxiety or depression later in life. This can affect family relationships and parenting.

This means that experiences during a boy’s childhood can have ripple effects decades later, shaping the environment his own children grow up in.

What this means for families

Taken together, the evidence from our review shows the importance of shared responsibility for pregnancy and parenthood.

Improving men’s health before pregnancy benefits not only men themselves but also their partners and future children. Yet most health advice about preparing for pregnancy still focuses almost entirely on women. In many countries, there is little information or support available for men who want to prepare for fatherhood.

Raising awareness is an important first step. Research shows that many men want to be involved in planning for pregnancy and supporting their partners – but they often don’t realise how their own health may influence outcomes.

For men who hope to become fathers, general health guidance needs to be followed: avoid smoking, limit alcohol, maintain a healthy weight, manage stress and seek medical advice for ongoing health conditions. Just as important, strong and supportive relationships between partners can help create healthier environments for future parenthood.

Our review suggests it’s time to rethink how we approach preparing for pregnancy. Instead of focusing only on women before pregnancy, a more effective approach should involve supporting the health and wellbeing of both boys and girls throughout their lives.

This includes addressing wider social factors such as education, mental health support, economic stability and childhood adversity. Experiences early in life shape later health behaviour and relationships, influencing the next generation.

Most healthcare systems are also simply not designed to support father’s involvement in preparation for pregnancy and parenthood. But men need to be included in conversations about reproductive health and couples should be supported to approach pregnancy preparation together.

More research is still needed to better understand the biological and social pathways linking men’s health to pregnancy and child outcomes. But our review makes one message clear: the health of the next generation does not begin with pregnancy – it begins much earlier, in the early lives and wellbeing of both parents.

Keith Godfrey receives funding from the National Institute for Health and Care Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (NIHR203319)) and the Wessex Medical Trust, Gerald Kerkut Charitable Trust and Rosetrees Trust.

Danielle Schoenaker receives funding from the National Institute for Health and Care Research (NIHR) through an NIHR Advanced Fellowship (NIHR302955) and the NIHR Southampton Biomedical Research Centre (NIHR203319).