Kotelchuck Milton, Lu Michael
MassGeneral Hospital for Children, Harvard Medical School, 125 Nashua Street, Suite 8402, Boston, MA, 02114, USA.
Maternal and Child Health Bureau, Health Resources and Services Administration, United States Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD, 20857, USA.
Matern Child Health J. 2017 Nov;21(11):2025-2039. doi: 10.1007/s10995-017-2370-4.
As part of the federal multi-agency conference on Paternal Involvement in Pregnancy Outcomes, the existing Fatherhood paradigm was expanded to include a new focus on Men's Preconception Health. This concept grew out of the women's preconception health movement and the maternal and child health (MCH) life course perspective, as well as pioneering research from the child development, public health data and family planning fields. It encourages a new examination of how men's preconception health impacts both reproductive outcomes and men's own subsequent health and development. This essay introduces the concept of men's preconception health and health care; examines its historical development; notes the challenges of its inclusion into fatherhood and reproductive health programs; and situates it within a longer men's reproductive health life course. We then briefly explore six ways men's preconception health and health care can have positive direct and indirect impacts-planned and wanted pregnancies (family planning); enhanced paternal biologic and genetic contributions; improved reproductive health biology for women; improved reproductive health practices and outcomes for women; improved capacity for parenthood and fatherhood (psychological development); and enhanced male health through access to primary health care. Research on men's preconception health and health care is very limited and siloed. We propose a research agenda to advance this topic in three broad domains: increasing the basic epidemiology and risk factor knowledge base; implementing and evaluating men's preconception health/fatherhood interventions (addressing clinical health care, psychological resiliency/maturation, and social determinants of health); and fostering more fatherhood health policy and advocacy research.
作为联邦多机构关于父亲参与妊娠结局会议的一部分，现有的父亲身份范式得到扩展，将对男性孕前健康的新关注纳入其中。这一概念源自女性孕前健康运动、母婴健康（MCH）的生命历程视角，以及儿童发展、公共卫生数据和计划生育领域的开创性研究。它促使人们重新审视男性孕前健康如何影响生殖结局以及男性自身随后的健康与发展。本文介绍了男性孕前健康与保健的概念；审视了其历史发展；指出将其纳入父亲身份和生殖健康项目所面临的挑战；并将其置于男性更长的生殖健康生命历程中。然后，我们简要探讨男性孕前健康与保健能够产生积极直接和间接影响的六种方式——计划内且期望的妊娠（计划生育）；增强父亲的生物学和遗传贡献；改善女性的生殖健康生物学状况；改善女性的生殖健康行为及结局；提高为人父母和父亲身份的能力（心理发展）；以及通过获得初级卫生保健增强男性健康。关于男性孕前健康与保健的研究非常有限且分散。我们提出一项研究议程，以在三个广泛领域推进这一主题：增加基础流行病学和风险因素知识库；实施并评估男性孕前健康/父亲身份干预措施（涉及临床卫生保健、心理适应力/成熟度以及健康的社会决定因素）；以及促进更多关于父亲身份健康政策和宣传的研究。
