Department of Urology, Oregon Heath & Science University, Portland, OR, USA.
Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA.
Nat Rev Urol. 2024 Sep;21(9):534-564. doi: 10.1038/s41585-024-00868-w. Epub 2024 Apr 25.
The prevalence of substance use globally is rising and is highest among men of reproductive age. In Africa, and South and Central America, cannabis use disorder is most prevalent and in Eastern and South-Eastern Europe, Central America, Canada and the USA, opioid use disorder predominates. Substance use might be contributing to the ongoing global decline in male fertility, and emerging evidence has linked paternal substance use with short-term and long-term adverse effects on offspring development and outcomes. This trend is concerning given that substance use is increasing, including during the COVID-19 pandemic. Preclinical studies have shown that male preconception substance use can influence offspring brain development and neurobehaviour through epigenetic mechanisms. Additionally, human studies investigating paternal health behaviours during the prenatal period suggest that paternal tobacco, opioid, cannabis and alcohol use is associated with reduced offspring mental health, in particular hyperactivity and attention-deficit hyperactivity disorder. The potential effects of paternal substance use are areas in which to focus public health efforts and health-care provider counselling of couples or individuals interested in conceiving.
全球物质使用的流行率正在上升，在生殖年龄的男性中最高。在非洲以及南美洲和中美洲，大麻使用障碍最为普遍，而在东欧和东南欧、中美洲、加拿大和美国，阿片类药物使用障碍则更为普遍。物质使用可能是导致全球男性生育力持续下降的原因之一，新出现的证据表明，父亲的物质使用与后代发育和结果的短期和长期不良影响有关。鉴于物质使用正在增加，包括在 COVID-19 大流行期间，这种趋势令人担忧。临床前研究表明，男性孕前物质使用可以通过表观遗传机制影响后代大脑发育和神经行为。此外，研究父代在产前阶段健康行为的人类研究表明，父亲的烟草、阿片类药物、大麻和酒精使用与降低后代的心理健康有关，尤其是多动和注意力缺陷多动障碍。关注父亲物质使用的潜在影响是集中公共卫生努力和卫生保健提供者咨询有生育意愿的夫妇或个人的领域。
