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Pregnancy intention, preconception health, health behaviours, and information and health advice seeking among expectant male partners

BMC Primary Care volume 26, Article number: 36 (2025) Cite this article

Abstract

Background

Attempting pregnancy as a conscious decision (pregnancy intention) can impact the likelihood that a future parent receives or seeks preconception health information, initiates discussions with health professionals, and ultimately optimises their health and behaviours in preparation for healthy pregnancy and child. Knowledge about the relationship between men’s preconception health behaviours and their pregnancy intention is only emerging.

Methods

This study aimed to describe the preconception health status, behaviours, information- and advice-seeking of male expectant partners, and to explore differences in these preconception factors based on pregnancy intention. An online retrospective cross-sectional survey was completed by male reproductive partners of pregnant females. Their pregnancy intention was assessed using the London Measure of Unplanned Pregnancy (LMUP). Participants were recruited via social media and all variables were self-reported by expectant partners. Chi-square tests examined differences by LMUP categories (planned or ambivalent/unplanned).

Results

Of 156 expectant partners who consented to survey participation, 138 completed all LMUP questions and were included in analysis. Most expectant partners reported their partner’s current pregnancy as planned (n = 90;65.2%), less than half reported looking for and finding information about becoming pregnant (40.0%). Expectant partners with planned pregnancy more often reported physical exercise three months before pregnancy compared with partners with unplanned/ambivalent pregnancy (p = 0.001). Expectant partners with ambivalent/unplanned pregnancy more often experienced longstanding illness, disability, or infirmity (p = 0.002) or disregarded contraception (p < 0.001). Despite perceiving good or excellent health, and undertaking physical exercise, numerous expectant partners with planned pregnancy had overweight. Further research exploring the reproductive life plan process for males with longstanding chronic illness or disability may help promote pregnancy planning and preconception health amongst this sub-population.

Conclusions

Further large-scale studies are needed to enable clinicians to better understand pregnancy intentions and preconception health of males and for policy makers to formulate health policies aimed at supporting male preconception health and awareness.

Peer Review reports

Introduction

Preconception is the period prior to conception when individuals and couples can seek or be provided with support to optimise their health status as well as reduce behaviours and environmental exposures that may contribute to adverse pregnancy and offspring outcomes [1]. However, an individual’s ability to capitalise on the opportunities afforded by the preconception period and seek care to promote health is affected by the degree to which becoming pregnant is a conscious decision, a complex multidimensional construct [2, 3] referred to as ‘pregnancy intention’. Intending pregnancy is an important public health measure [4], and a principal preconception concept for couples and individuals alike, which may result in pregnancy planning and preparation. However, unplanned pregnancies, including pregnancies that are either mistimed [5] or occur when parents are ambivalent to becoming pregnant, are also common [3, 6]. Healthful preconception behaviours such as physical activity [7] or taking folate [8] and personal attributes such as relationship stability [9], and health seeking information in preparation for pregnancy [10] have been associated with intended pregnancies among females.

Public awareness must rebalance the gaze and consider males too provide genetic contributions toward their offspring and therefore healthy male sperm is a vital consideration before pregnancy to ensure healthy pregnancy and offspring outcomes. However, circumstances such as being overweight or obese can negatively impact sperm quality [11] and adversely influence pregnancy and offspring outcomes and fertilisation rates [12]. Opportunities for males to receive or seek preconception health information, initiate discussions with health professionals, and optimise health and behaviours in preparation for a healthy pregnancy and child are important aspects of preconception health and care which are interrelated with pregnancy intention. Preconception awareness for males is considered by a public health and health promotion agency in Australia which has developed a male preconception checklist that outlines the importance of men managing their weight, restricting smoking, and exercising regularly as well as booking a preconception health check with a general practitioner (GP) [13]. Males with pregnant partners (referred to here as ‘expectant partners’) are role models for their future children so may have considered altering their health behaviours before pregnancy, to minimise adverse pregnancy and offspring outcomes [14], in turn providing a foundation for positive contributions toward family health, a stable family environment, and an active role in a child’s life [15, 16],

Research from the United Kingdom has reported that up to 20% of expectant partners draw upon sources of preconception diet and lifestyle information from peers, family, and friends and via books and online resources to optimise their preconception health and wellbeing for the sake of their expectant children [17]. Health services can play a key role among males during preconception by assisting to source information and to provide advice on paternal preconception matters [18, 19].

Pivoting from intended to unintended pregnancies, approximately 40% of pregnancies globally are estimated to be unintended [20], which has been associated with unhealthy behaviours among women such as preconception substance use [21], smoking and alcohol consumption [22], and adverse maternal and infant outcomes [23]. For males, unintended pregnancies are often reported with insecure financial circumstances, less stable relationships, and false assumptions about contraception use [24]. Unintended pregnancies, alongside the problematic approach to motivate men to attend primary health-services [25] and GPs’ limited knowledge about factors which affect male fertility [26], hinder progress towards paternal preconception care. Several barriers to discussing fertility and preconception health with males are reported among GP’s [26] and unwavering challenges endure for primary health services generally especially due to a lack of male preconception primary health-care initiatives [25]. As such, preconception care discussions are not always initiated with males who consult with health care services or who attend primary health care [26] and exposure to a range of preconception services and information, including immunization checking, dietary advice, and smoking cessation assistance is also sometimes absent. Consequently, males may not always consider the impact of their lifestyle behaviours and modifiable risk factors on either their own health or that of their offspring [17].

To provide further evidence on how to guide and support males during preconception and when planning a pregnancy, this study aimed to describe the preconception health status, behaviours, information, and advice-seeking of male expectant partners, and to explore differences in these preconception factors based on pregnancy intention.

Materials and methods

Study design

An observational retrospective cross-sectional study utilizing data from an online survey was conducted between December 2020 and September 2021. The survey involved a convenience sample of pregnant women and their expectant partners. Informed written consent was obtained from all participants and the study was performed in accordance with the Declaration of Helsinki [27]. Ethics approval was obtained by University of Technology Sydney (UTS) Human Research Ethics Committee (HREC) (ETH20-4726).

Participants and survey administration

Eligible survey participants included those who self-identified as a female, aged 18 to 49 years, and at any stage of pregnancy living in Australia. Expectant partners of eligible participants were also eligible to participate. Targeted advertising was utilized on social media platforms (i.e. Instagram, Facebook, Twitter) to recruit participants and an incentive was provided. A screening instrument was utilized to ensure that participants met the eligibility criteria and to collect their name and email address. Any individual who met the study eligibility criteria and consented to participate was able to complete the survey via the online survey platform Qualtrics™. Eligible females received a hyperlink whereby they were instructed to complete their own survey and forward the second survey onto their partners. Eligible male expectant partners were also directly targeted for recruitment and, following consent, received a hyperlink being instructed to complete their own survey and forward the second survey onto their pregnant partners.

Analysis provided in this paper includes only the male expectant partners of eligible study participants i.e. not female partners.

Survey instrument and data

A paper-based survey was developed and tested by three individuals, feedback was provided which resulted in the survey being built into Qualtrics™ and retested before finalising (Supplementary Material 1). This survey of partners of pregnant women was developed in tandem with the survey instrument designed for pregnant women. The Expectant partner’s pre-pregnancy health information survey consists of 80-items across five sections including preliminary survey consent, date, and post survey comments (4-items), [1] “About you” (sociodemographic characteristics, height and weight) (15-items); [2] “Your current pregnancy” (retrospective assessment of the degree and timing of pregnancy planning incorporating the version of the London Measure of Unplanned Pregnancy [LMUP] for partners [28] (12-items); [3] “Your health behaviours” (history of and changes in preconception health and health behaviours) (31-items); [4] “Prepregnancy health information and advice” (knowledge on the importance of preconception health, the content of preconception care, and the source(s) of this information) (10-items); and [5] “Your health history” (health history, general health status, and pregnancy history) (8-items).

Sociodemographic characteristics

The survey obtained participant gender, age, residential postcode, private health insurance cover, highest qualification completed, employment status, relationship status, financial management status, identity as Aboriginal or Torres Strait Islander, first language spoken, country of birth, and health care card access.

Health status and health history

Expectant partners rated their current general health status (excellent-poor), responded to questions about any longstanding illness and health conditions diagnosed (3 months before partner’s pregnancy) and reported their body weight and height. The survey also asked about participant’s contraception use (6 months before pregnancy) and if they had have ever smoked and/or ever consumed alcohol.

Health behaviours

Survey questions identified participant’s actions in preparing for pregnancy overall (Stop/cut back smoking and alcohol, eat healthier, seek medical advice, use vitamin supplements). Health behaviours were then identified based upon three preconception time periods: three, six and twelve months prior to pregnancy. Behaviours identified three months prior to pregnancy included alcohol consumption, smoking, and physical activity levels plus the consulting with health professionals for ongoing assistance. Health behaviours in the six months prior to pregnancy that were identified included following a weight loss diet, testing for sexually transmitted infections (STIs), and use of contraception methods. Health behaviours in the 12 months prior to pregnancy that were identified included any actions before partner became pregnant (visit a dentist, check immunizations) and consulting with a health professional about their partner becoming pregnant.

Preconception health information and advice

Questions further established if expectant partners had searched for information about becoming pregnant, and if so, asked about the source of this information and who (which partner) did this information related to. Also, questions explored whether expectant partners were provided with information about diet and lifestyle options for example eating a healthy diet, smoking, consuming alcohol, or taking vitamin C supplements before pregnancy.

Pregnancy intention

Pregnancy intention was assessed using the London Measure of Unplanned Pregnancy (LMUP) for women’s partners; a measure developed in the UK which identifies the degree of planning for a current/recent pregnancy [28].

Data analysis

Survey data were imported into Stata 17.1 and prepared for analysis by the research team. Survey participants comprise those who consented to participate in the survey, reported their sex as male, and completed all the survey questions directly related to the LMUP. The LMUP was scored as per the instrument’s guide; participants response to each item score a minimum 0 and maximum 2 which then combine to a total score [29]. Technical issues with the online survey did not allow the last question of the LMUP to select multiple items but only one item. As a result, the maximum score awarded for this question is 1 instead of the standard maximum of 2. The LMUP scoring guide was followed for analysis. Two participants had a single missing value in one LMUP variable and were excluded from the analysis; imputation was not considered.

Based on the LMUP scoring, new categorical variables were generated as ‘Planned’ (LMUP score 10 or 11), ‘Ambivalent’ (between 4 and 9), or `Unplanned’ pregnancy (3 or less) [28]. A binary variable was then generated to combine the ‘Ambivalent’ and `Unplanned’ categories (ambivalent/unplanned) as only one participant had a score of 3 or less [30]. Data was tabulated into categories describing participant demographics, health status and history, health behaviours and health information. Variables of interest were then analysed according to planned and ambivalent/unplanned pregnancies.

Binary variables were created from categorial variables to determine descriptive statistics for health status and health history, participant health behaviours, and health information and advice. Body mass index (BMI) was calculated using the participants height and weight and then categorized according to the World Health Organization classifications [31]. Participants with missing data were not included in the analysis. Chi-square tests were utilized to examine differences by LMUP categories (planned or ambivalent/unplanned). If a cell count was less than 5, a Fisher’s exact test was conducted. ANOVA tests were employed to compare differences in medians according to LMUP category for continuous variables. An alpha value below 0.05 was considered statistically significant and effect size was determined using Cramer’s V [32]. Results for Cramer’s V range between 0 and 1, greater values indicate stronger associations between variables; > 0.25 equals a very strong association, > 0.15 equals a strong association, > 0.10 equals a moderate association, > 0.05 equals a weak association and > 0 equals a very weak association [33].

Results

A total of 156 expectant partners were eligible and provided consent to participate in the survey. The LMUP for partners includes six questions and has a maximum total score of 12 with higher scores indicating a greater degree of pregnancy planning [30] (Supplementary Material 2). Most expectant partners (n = 138) completed all the LMUP questions and were included in the analysis. The majority of expectant partners had a planned pregnancy (n = 90;65.2%).

Demographics

Overall, the most common age range of expectant partners was 30–39 years (61.7%) and most were employed full-time (89.1%) and married (70.2%) (Table 1). A small percentage of expectant partners identified as Aboriginal or Torres Strait Islander (3.6%). When comparing expectant partners with planned pregnancy and expectant partners with ambivalent/unplanned pregnancy, a very strong association was identified between the LMUP categories and relationship status (V = 0.26;p = 0.006) indicating that expectant partners with planned pregnancy were more often married. A moderate association was identified for expectant partners with an ambivalent/unplanned pregnancy who more often spoke a primary language other than English (V = 0.16;p = 0.05).

Table 1 Sociodemographic characteristics of expectant male partners
Full size table

Health status and health history

Most expectant partners reported their general health status as “good” (60.4%) and approximately half (49.2%) reported no contraception use in the 6 months before their partners pregnancy as they were trying to conceive (Table 2). According to the BMI classifications, expectant partners with planned pregnancy were most often overweight (42.0%). A comparison of the LMUP categories provided evidence to support very strong associations; expectant partners with ambivalent/ unplanned pregnancy more often had a longstanding illness, disability, or infirmity (V = 0.31;p = 0.005) and more often did not use contraception (V = 0.37;p < 0.001).

Table 2 The health status and health history of expectant male partners
Full size table

Preconception health behaviours

Numerous expectant partners reported physical exercise in the three months before their partner’s pregnancy (69.5%); generally, expectant partners reported an average number of five hours of physical activity per week (SD 3.0–7.5) (Table 3). The majority of expectant partners had ever consumed alcohol (84.7%) and approximately one third of expectant partners had ever smoked (36.3%). Almost one third of expectant partners reported seeing any health professional 12 months before their partner’s pregnancy (32.2%). A small number of expectant partners reported using folic acid before their partner’s pregnancy (5.0%).

Table 3 The health behaviours of expectant male partners
Full size table

A very strong association was observed for physical activity three months before the partner’s pregnancy with LMUP category (V = 0.27;p = 0.001) indicating that a greater proportion of expectant partners with planned pregnancy reported physical exercise. A very strong association was identified between checking immunizations 12 months before partner’s pregnancy and planned pregnancy (V = 0.26;p = 0.26) while a strong association was identified between having ever smoked and reporting an ambivalent/unplanned pregnancy (V = 0.24;p = 0.005).

Preconception health information and advice

Almost one third of all expectant partners reported looking for and finding information about becoming pregnant (31.8%) (Table 4). A large proportion of expectant partners sourced preconception information from the internet (92.0%) and in many instances the preconception information related to both males and females (76.0%). When preparing for pregnancy, many expectant partners received information regarding immunizations (21.1%), smoking (20.0%), and alcohol (20.0%), yet fewer received information about maintaining a healthy weight (11.5%) or sexually transmitted diseases (11.5%). Upon comparing LMUP categories, a strong association was identified between planned pregnancy and looking for and finding information about becoming pregnant (V = 0.23;p = 0.005).

Table 4 Preconception health information and advice for expectant male partners
Full size table

Discussion

This study on paternal pregnancy intention and planning identified several key findings of importance for public health and reproductive health broadly and more specifically for expectant partners preconception health and care, and their efforts to seek, source, identify, and consult for preconception information and advice. According to the LMUP for Women’s Partners [28], the proportion of expectant partners with a planned pregnancy in our study (69%) was lower than in other studies exploring males’ pregnancy intention (81–95%) [24, 34]. Our study also reported a proportion of expectant partners with planned pregnancy less than the planned pregnancy rate generally reported for women (83%) [35] and similar to the estimated global planned pregnancy rate (60%) [20]. The public health implications of this research rebalance the social gaze to consider the impact of male health during preconception and to prompt males to take opportunities to sustain health during preconception. Noteworthy findings within our study are discussed below.

When comparing the sociodemographic characteristics of expectant partners in our study according to pregnancy intention, some findings align with existing evidence describing the target population. For example, male expectant partners with intended pregnancy were most commonly aged 30–39 age [36], were often in committed relationships [37], and generally did not report issues with financial manageability [38]. Other findings in our study present potential areas for exploration and future research; a significant proportion of expectant partners who had a first language other than English or who had ever smoked reported ambivalent pregnancies.

A large proportion of expectant partners in our study with a planned pregnancy undertook physical activity in the three months prior to their partner’s pregnancy (69.5%), averaging five physical activity hours per week. Regular exercise plays an important role in regulating body weight and BMI [39], and with general physical function and health related well-being; [40] a lack of exercise is considered a major cause of chronic disease [41]. However, the health benefits of preconception interventions including regular exercise is only emerging for reproductive males [13]. Our finding of expectant partners undertaking physical activity during preconception is promising and may even substantiate why many expectant partners in our study report their health status as good or excellent. Despite perceiving their health as good or excellent, and undertaking physical activity, numerous expectant partners who planned pregnancy in our study had overweight status with a BMI between 25.0 and 29.9 (42%). The literature exploring males having overweight or obese suggests that their offspring are more likely to also have overweight or obesity [42, 43] and asthma [44]. Expectant partners having overweight and intending pregnancy should feel supported to optimise their body weight and reduce their risks, given that a sustained and increased BMI can signpost numerous ailments [45] and, along with waist and hip measurements, presents a health risk factor [46]. Although, according to BMI, having overweight does not always equate to being `unhealthy’ and boundaries can seem blurred between BMI and health [47] due to the limitations of BMI due to its lack of distinction between fat and muscle tissue or determining body weight distribution [48]. Expectant partners having the perception of reasonable health yet living with overweight underscores the importance for males planning a pregnancy to be aware that despite undertaking physical activity, their preconception BMI may influence the health of their child later in life. Males during the preconception period and specifically the 3-month period prior to conception require further exploration to determine the influence of their regular exercise on pregnancy and offspring outcomes and to determine the efficacy of paternal preconception health and care treatment plans incorporating regular exercise.

Expectant partners with planned pregnancy in our study actively sought information and advice and often used the internet as a source of preconception information (92.0%). More broadly, previous research has shown that how males plan and prepare for pregnancy is varied; [34] one Australian study identified that males often only seek information regarding fertility when experiencing difficulties conceiving [49] while another study from England suggests that one in two males have looked at information about their partners pregnancy before conception from a variety of sources [17]. For many males, seeking information or advice about pregnancy planning may now be a process governed online and by social media whereby familiar digitized social platforms are used to support decision making when planning a pregnancy [50]. Thus, online resources, social media platforms, and primary health care services all play a key role and have an onus to promote and provide accurate and reliable preconception information to reproductively aged males, especially those who are planning pregnancy.

Our study also shows that close to one quarter (22.2%) of expectant partners who planned a pregnancy completed immunization checks in the 12 months prior to their partners pregnancy and that approximately one fifth (21.1%) of expectant partners who planned a pregnancy received information or advice about immunization. The research exploring immunisation status during preconception is primarily focused on women [51,52,53] and checks for females before pregnancy are actively encouraged in the resources available for pregnancy planning [54, 55], are advocated by Governments worldwide [56, 57], and also recommend in the guidelines utilized by GPs for preventive activities in general practice [58]. As messages are directed and disseminated mainly toward the birthing parent not the couple or the male [59], and even when males check immunizations during preconception, immunization information will not always translate to immunisation currency or even immunization acceptance. Our results regarding immunisation may underscore the emphasis placed on immunization information, advice, and messages during the times of COVID-19 for both women and men [60]. Post COVID-19, preconception equality advocates that males should also reduce the risks of various infectious diseases to promote health [61] and thus preconception immunization status screening and information should be incorporated into consultations for all reproductive males intending pregnancy, including males who report any longstanding illness, disability, or infirmity.

Another key finding in this study is that expectant partners who report any longstanding illness, disability, or infirmity (15%) more often have an ambivalent or unplanned pregnancy than a planned pregnancy. Evidence suggests that approximately one in three adults live with multiple chronic conditions [62]. Males with longstanding chronic illness, including preconception paternal comorbidity such as metabolic syndrome, threaten the health of their gametes and have been associated with higher odds of pre-term birth or low birth weight than males without comorbidities [63]. Previous research also identifies that the partners of disabled fathers are at higher risk of unintended pregnancy compared with the partners non-disabled fathers [64]. Hence, for expectant partners with health-related issues which may manifest as a longstanding chronic illness, disability, or infirmity, their partner’s pregnancy may not always be intended or may even result in adverse pregnancy outcomes [65]. Therefore, tailoring a reproductive life plan specifically to males with longstanding chronic illness or disability may help promote pregnancy intention and paternal preconception health amongst this sub-population. All reproductive males, including those with longstanding chronic illness or a disability, are likely to benefit from preconception care and require targeted information regarding the importance of pregnancy planning and preparation.

Strengths and limitations

Our study captures the preconception health behaviours and information seeking behaviours of expectant partners through the lens of pregnancy intention, nevertheless, it is important to acknowledge several limitations. Firstly, this study was cross-sectional in nature and therefore represents the preconception intentions, health, health behaviours, and information and health advice seeking among expectant partners in a 12-month period only. Expectant partners were recruited via social media, and completed an online survey, both processes which can be predisposed to data collection bias or sampling and selection bias [66]. Although social media does have hundreds of millions of users, and is becoming more frequently used by the general public [66], utilizing social media to recruit survey participants for this study may not have provided a true representation of males during preconception. Further, recruiting only males with pregnant partners also does not provide a true representation of males during preconception. Due to the reliance upon self-reported data in the survey, there is potential for response bias whereby participants may have provided socially desirable responses which has been mitigated by ensuring questions were articulated without an emphasis on socially acceptable answers or being right or wrong [67]. The self-reported measures identified in this study were also not considered alongside objective data which would enhance the rigour of the fundings. Further, a survey data error meant that only five of the six questions in the LMUP for women’s partners survey could be allocated the maximum score. Also, the use of LMUP for Partners has only been piloted in the UK [28] and so has not been validated for Australian expectant partners as has the LMUP among pregnant Australian women [68]. Finally, due to the sample size, there was insufficient statistical power to perform multivariate analysis. Despite these limitations, this study still provides valuable insights to an understudied population on a topic that is critical to public health for multiple generations.

Conclusion

The majority of expectant partners in our study had a planned pregnancy, yet close to one third of the expectant partners in our study remain ambivalent about their current pregnancy. Key differences, including undertaking physical activity and checking immunisations, were evident in the health behaviours of expectant partners with a planned pregnancy compared with ambivalent/unplanned pregnancy. Our study establishes a foundation for further large-scale research to be conducted to build a knowledge base for clinicians to better understand preconception health for males and their information and advice seeking behaviours and also enable policy makers to formulate health policies and initiatives aimed at improving male preconception health and awareness.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

GP:

General Practitioner

RACGP:

Royal Australian College of General Practitioners

UTS:

University of Technology Sydney

HREC:

Human Research Ethics Committee

LMUP:

London Measure of Unplanned Pregnancy

STI’s:

Sexually transmitted infections

BMI:

Body mass index

References

  1. World Health Organization [WHO]. editor Meeting to develop a global consensus on preconception care to reduce maternal and childhood mortality and morbidity meeting to develop a global consensus on preconception care to reduce maternal and childhood mortality and morbidity 2012; Geneva: World Health Organization [WHO].

  2. Mumford SL, Sapra KJ, King RB, Louis JF, Buck Louis GM. Pregnancy intentions-a complex construct and call for new measures. Fertil Steril. 2016;106(6):1453–62.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cutler A, McNamara B, Qasba N, Kennedy HP, Lundsberg L, Gariepy A. I just don’t know: an exploration of women’s ambivalence about a new pregnancy. Womens Health Issues. 2018;28(1):75–81.

    Article  PubMed  Google Scholar 

  4. Dorney E, Barrett G, Hall J, Black K. Measures of pregnancy intention: Why use them and what do they tell us? Seminars in Reproductive Medicine. 2023;40:229 – 34.

  5. Gómez AM, Arteaga S, Villaseñor E, Arcara J, Freihart B. The misclassification of ambivalence in pregnancy intentions: a mixed-methods analysis. Perspect Sex Reprod Health. 2019;51(1):7–15.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Taft AJSMB, Mazza K, Hussainy D, S;, Lucke J. Unintended and unwanted pregnancy in Australia: a cross-sectional, national random telephone survey of prevalence and outcomes. Med J Aust. 2018;209(9):407–8.

    Article  PubMed  Google Scholar 

  7. Din HN, Strong D, Singh-Carlson S, Corliss HL, Hartman SJ, Madanat H, et al. Association between pregnancy intention and preconception health behaviors. Cancer. 2022;128(3):615–23.

    Article  PubMed  Google Scholar 

  8. Chuang CH, Hillemeier MM, Dyer AM, Weisman CS. The relationship between pregnancy intention and preconception health behaviors. Prev Med. 2011;53(1–2):85–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Maddow-Zimet I, Lindberg L, Kost K, Lincoln A. Are pregnancy intentions Associated with transitions into and out of marriage? Perspect Sex Reprod Health. 2016;48(1):35–43.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Lang AY, Harrison CL, Boyle JA. Australian women’s information-seeking preferences and needs in preparation for pregnancy. Health Promot J Austr. 2023;34(1):123–8.

    Article  PubMed  Google Scholar 

  11. Wang EY, Huang Y, Du QY, Yao GD, Sun YP. Body mass index effects sperm quality: a retrospective study in Northern China. Asian J Androl. 2017;19(2):234–7.

    Article  PubMed  Google Scholar 

  12. Hoek J, Schoenmakers S, van Duijn L, Willemsen SP, van Marion ES, Laven JSE, et al. A higher preconceptional paternal body mass index influences fertilization rate and preimplantation embryo development. Andrology. 2022;10(3):486–94.

    Article  CAS  PubMed  Google Scholar 

  13. Your Fertility. Preconception Checklist for Men 2023 [Available from: https://www.yourfertility.org.au/sites/default/files/2020-10/Pre-conception%20Checklist%20for%20Men.pdf

  14. Carter T, Schoenaker D, Adams J, Steel A. Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies. BMC Public Health. 2023;23(1):509.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kotelchuck M, Lu M. Father’s role in preconception health. Matern Child Health J. 2017;21(11):2025–39.

    Article  PubMed  Google Scholar 

  16. Kotelchuck M. The impact of father’s health on reproductive and infant health and development. Engaged Fatherhood for Men, Families and Gender Equality. 2022:31.

  17. Shawe J, Patel D, Joy M, Howden B, Barrett G, Stephenson J. Preparation for Fatherhood: a survey of men’s preconception health knowledge and behaviour in England. PLoS ONE. 2019;14(3):e0213897.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Dorney E, Black K. Preconception care. Australian J Gen Practitioners. 2018;47:424–9.

    Article  Google Scholar 

  19. Steel A, Gibson H, Adams J, Schoenaker D. What preconception health services would the public find when searching the internet in Australia? Results from a simulated internet-search study. BMC Health Serv Res. 2024;24(1):93.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Yargawa J, Machiyama K, Ponce Hardy V, Enuameh Y, Galiwango E, Gelaye K, et al. Pregnancy intention data completeness, quality and utility in population-based surveys: EN-INDEPTH study. Popul Health Metrics. 2021;19(1):6.

    Article  Google Scholar 

  21. Shafique S, Umer A, Innes KE, Rudisill TM, Fang W, Cottrell L. Preconception Substance Use and risk of unintended pregnancy: pregnancy risk Assessment Monitoring System 2016-17. J Addict Med. 2022;16(3):278–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Yu P, Jiang Y, Zhou L, Li K, Xu Y, Meng F, et al. Association between pregnancy intention and smoking or alcohol consumption in the preconception and pregnancy periods: a systematic review and meta-analysis. J Clin Nurs. 2022;31(9–10):1113–24.

    Article  PubMed  Google Scholar 

  23. Nelson HD, Darney BG, Ahrens K, Burgess A, Jungbauer RM, Cantor A, et al. Associations of unintended pregnancy with maternal and Infant Health outcomes: a systematic review and Meta-analysis. JAMA. 2022;328(17):1714–29.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kågesten A, Bajos N, Bohet A, Moreau C. Male experiences of unintended pregnancy: characteristics and prevalence. Hum Reprod. 2015;30(1):186–96.

    Article  PubMed  Google Scholar 

  25. O’Brien AP, Hurley J, Linsley P, McNeil KA, Fletcher R, Aitken JR. Men’s Preconception Health: a primary health-care viewpoint. Am J Mens Health. 2018;12(5):1575–81.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Hogg K, Rizio T, Manocha R, McLachlan RI, Hammarberg K. Men’s preconception health care in Australian general practice: GPs’ knowledge, attitudes and behaviours. Aust J Prim Health. 2019;25(4):353–8.

    Article  PubMed  Google Scholar 

  27. World Medical Assocation [WMA]. Declaration of Helsinki 2024 [Available from: https://www.wma.net/what-we-do/medical-ethics/declaration-of-helsinki/

  28. Barrett G, Hall JA, Howden B, Patel D, Shawe J, Stephenson J. Evaluation of the psychometric properties of a version of the London measure of unplanned pregnancy for women’s partners. Int J Mens Social Community Health. 2020;3(1):e65–77.

    Article  Google Scholar 

  29. Dr Geraldine Barrett. Scoring the LMUP [Available from: http://measure.ascody.co.uk/score.htm

  30. Hall JA, Barrett G, Copas A, Stephenson J. London measure of unplanned pregnancy: guidance for its use as an outcome measure. Patient Relat Outcome Measures. 2017:43–56.

  31. World Health Organization. [WHO]. A healthy lifestyle - WHO Recommendations 2010.

  32. Tomczak M, Tomczak E. The need to report effect size estimates revisited. An overview of some recommended measures of effect size. 2014.

  33. Akoglu H. User’s guide to correlation coefficients. Turkish J Emerg Med. 2018;18.

  34. Bodin M, Käll L, Tydén T, Stern J, Drevin J, Larsson M. Exploring men’s pregnancy-planning behaviour and fertility knowledge:a survey among fathers in Sweden. Ups J Med Sci. 2017;122(2):127–35.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Goossens J, Beeckman D, Van Hecke A, Delbaere I, Verhaeghe S. Preconception lifestyle changes in women with planned pregnancies. Midwifery. 2018;56:112–20.

    Article  PubMed  Google Scholar 

  36. Kaltsas A, Moustakli E, Zikopoulos A, Georgiou I, Dimitriadis F, Symeonidis EN et al. Impact of Advanced Paternal Age on Fertility and risks of Genetic disorders in offspring. Genes (Basel). 2023;14(2).

  37. Hashemzadeh M, Shariati M, Mohammad Nazari A, Keramat A. Childbearing intention and its associated factors: a systematic review. Nurs open. 2021;8(5):2354–68.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Roberts E, Metcalfe A, Jack M, Tough SC. Factors that influence the childbearing intentions of Canadian men. Hum Reprod. 2011;26(5):1202–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Lee HS, Lee J. Effects of Exercise interventions on Weight, Body Mass Index, lean body Mass and Accumulated Visceral Fat in overweight and obese individuals: a systematic review and Meta-analysis of Randomized controlled trials. Int J Environ Res Public Health. 2021;18(5).

  40. Joel TF, Michael CH, Luke TM, Kade D. Therapeutic effects of aerobic and resistance exercises for cancer survivors: a systematic review of meta-analyses of clinical trials. Br J Sports Med. 2018;52(20):1311.

    Article  Google Scholar 

  41. Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012;2(2):1143–211.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Xu R, Zhao W, Tan T, Li H, Wan Y. Paternal body mass index before conception associated with offspring’s birth weight in Chinese population: a prospective study. medRxiv. 2021:2021.06.17.21258438.

  43. Yang S, Zhou A, Xiong C, Yang R, Bassig BA, Hu R, et al. Parental body Mass Index, Gestational Weight Gain, and risk of Macrosomia: a Population-based case-control study in China. Paediatr Perinat Epidemiol. 2015;29(5):462–71.

    Article  PubMed  Google Scholar 

  44. Bowatte G, Bui DS, Priyankara S, Lowe AJ, Perret JL, Lodge CJ, et al. Parental preconception BMI trajectories from childhood to adolescence and asthma in the future offspring. J Allergy Clin Immunol. 2022;150(1):67–e7430.

    Article  PubMed  Google Scholar 

  45. Ansari S, Haboubi H, Haboubi N. Adult obesity complications: challenges and clinical impact. Ther Adv Endocrinol Metab. 2020;11:2042018820934955.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Australian Government. Australian Institute of Health and Welfare [AIHW]. Overweight and obesity 2017 [Available from: https://www.aihw.gov.au/reports/risk-factors/risk-factors-to-health/contents/overweight-and-obesity

  47. Gutin I. BMI We Trust: reframing the body Mass Index as a measure of Health. Soc Theory Health. 2018;16(3):256–71.

    Article  PubMed  Google Scholar 

  48. Kolimechkov S, Petrov L. The Body Mass Index: A Systematic Review. 2020;3:21 – 7.

  49. Pearson L, Holton S, McLachlan R, Hammarberg K. Australian men’s fertility information seeking attitudes and behaviour: a qualitative investigation. Sex Reproductive Healthc. 2021;29:100621.

    Article  Google Scholar 

  50. Walker R, Blumfield M, Truby H. Beliefs and advice-seeking behaviours for fertility and pregnancy: a cross-sectional study of a global sample. J Hum Nutr Dietetics. 2018;31(4):486–95.

    Article  CAS  Google Scholar 

  51. Chivers BR, Boyle JA, Lang AY, Teede HJ, Moran LJ, Harrison CL. Preconception health and lifestyle behaviours of women planning a pregnancy: a cross-sectional study. J Clin Med. 2020;9(6).

  52. Musgrave L, Homer C, Gordon A. Knowledge, attitudes and behaviours surrounding preconception and pregnancy health: an Australian cross-sectional survey. BMJ open. 2023;13(1):e065055.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Lang AY, Harrison CL, Barrett G, Hall JA, Moran LJ, Boyle JA. Opportunities for enhancing pregnancy planning and preconception health behaviours of Australian women. Women Birth. 2021;34(2):e153–61.

    Article  PubMed  Google Scholar 

  54. The National Health Service (NHS). Planning your pregnancy 2023 [Available from: https://www.nhs.uk/pregnancy/trying-for-a-baby/planning-your-pregnancy/

  55. Family Planning NSW. Reproductive & sexual health. Pre-pregnancy planning and healthy pregnancy 2022 [Available from: https://www.fpnsw.org.au/factsheets/individuals/pregnancy/pre-pregnancy-planning-and-healthy-pregnancy

  56. Australian Government -. (Department of Health and Aged Care). Immunisation for pregnancy 2023.

  57. Centers for Disease Control and Prevention [CDC]. Vaccines before pregnancy 2021 [Available from: https://www.cdc.gov/vaccines/pregnancy/vacc-before.html

  58. Royal Australian College of General Practitioners [RACGP]. Guidelines for preventive activities in general practice [Red Book] 2021. Available from: https://www.racgp.org.au/getattachment/1ad1a26f-9c8b-4e3c-b45b-3237272b3a04/Guidelines-for-preventive-activities-in-general-practice.aspx

  59. Shawe J, Delbaere I, Ekstrand M, Hegaard HK, Larsson M, Mastroiacovo P, et al. Preconception care policy, guidelines, recommendations and services across six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom. Eur J Contracept Reproductive Health Care. 2015;20(2):77–87.

    Article  Google Scholar 

  60. Tavilani A, Abbasi E, Kian Ara F, Darini A, Asefy Z. COVID-19 vaccines: current evidence and considerations. Metabol Open. 2021;12:100124.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Rabiei Z, Shariati M, Mogharabian N, Tahmasebi R, Ghiasi A, Motaghi Z. A review of guidelines, recommendations, and framework of men’s preconception care. Reproductive Dev Med. 2022;6(4):254–9.

    Google Scholar 

  62. Hajat C, Stein E. The global burden of multiple chronic conditions: a narrative review. Prev Med Rep. 2018;12:284–93.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Kasman AM, Zhang CA, Li S, Stevenson DK, Shaw GM, Eisenberg ML. Association of preconception paternal health on perinatal outcomes: analysis of U.S. claims data. Fertil Steril. 2020;113(5):947–54.

    Article  PubMed  Google Scholar 

  64. Namkung EH, Mitra M. Birth intentions among US fathers with disabilities. Disabil Health J. 2021;14(3):101097.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Murugappan G, Li S, Leonard SA, Winn VD, Druzin ML, Eisenberg ML. Association of preconception paternal health and adverse maternal outcomes among healthy mothers. Am J Obstet Gynecol MFM. 2021;3(5):100384.

    Article  PubMed  Google Scholar 

  66. Morstatter F, Liu H. Discovering, assessing, and mitigating data bias in social media. Online Social Networks Media. 2017;1:1–13.

    Article  Google Scholar 

  67. Althubaiti A. Information bias in health research: definition, pitfalls, and adjustment methods. J Multidiscip Healthc. 2016;9:211–7.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Lang AY, Hall JA, Boyle JA, Harrison CL, Teede H, Moran LJ, et al. Validation of the London measure of unplanned pregnancy among pregnant Australian women. PLoS ONE. 2019;14(8):e0220774.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

TC is funded under a Commonwealth Government research training stipend (RTP stipend). DS is supported by the National Institute for Health and Care Research (NIHR) through an NIHR Advanced Fellowship (NIHR302955) and the NIHR Southampton Biomedical Research Centre (NIHR203319). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

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Authors and Affiliations

  1. School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, 2006, Australia

    Tristan Carter, Jon Adams & Amie Steel

  2. School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK

    Danielle Schoenaker

  3. MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK

    Danielle Schoenaker

  4. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Danielle Schoenaker

  5. Level 8, Building 10 235-253 Jones St Ultimo, NSW, 2006, Australia

    Tristan Carter

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AS initiated the survey, administered the survey process, and collected data. TC analyzed and tabulated the data and was a major contributor to the writing of the manuscript. This manuscript was overseen by faculty supervisors AS, JA, & DS. All authors read and approved the final manuscript.

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Correspondence to Tristan Carter.

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Study ethics approval was obtained from the Human Research Ethics Committee (HREC) at the University of Technology Sydney (UTS) (ETH20-4726), in accordance with the Declaration of Helsinki. Informed consent was obtained from each participant prior to survey commencement.

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Not applicable.

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The authors declare no competing interests.

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Carter, T., Schoenaker, D., Adams, J. et al. Pregnancy intention, preconception health, health behaviours, and information and health advice seeking among expectant male partners. BMC Prim. Care 26, 36 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12875-025-02703-6

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BMC Primary Care

ISSN: 2731-4553

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