The health beliefs, attitudes, and intentions of males toward pregnancy planning and preconception health and care: a systematic review

INTRODUCTION: The preconception period is an opportunity to address health-related behaviours to optimise pregnancy and child health outcomes. However, preconception health research and practice are primarily focused on females while similar attention on males remains underdeveloped. To address evidence gaps and inform effective paternal preconception health support, the aim of this systematic review was to identify the health beliefs, attitudes, and intentions of males toward pregnancy planning and preconception health and care. METHODS: A literature search was conducted in seven databases: Medline, Embase, PubMed, CINAHL, PsycINFO, Scopus, and Web of Science to identify original research regarding pregnancy planning or preconception health beliefs, attitudes, and/or intentions among generally healthy adult males. Methodological rigour of included studies was assessed using the Newcastle Ottawa Scale (NOS) and the Critical Appraisal Skills Programme (CASP) Qualitative Studies checklist. RESULTS: Nine studies were included; cross sectional studies (n=6); a qualitative exploratory case study (n=1); a mixed method study (n=1) and a study incorporating qualitative and quantitative surveys (n=1). Analysis identified three broad themes: 1) Importance of Preconception Health and Care; 2) Paternal Preconception Behaviours; and 3) Inequalities in Preconception Health and Preconception Care. Findings reveal 1) Many males did not attend a preconception care consultation and believed it was not needed, or they already knew enough about a healthy pregnancy. 2) Males often agreed that smoking and alcohol consumption can affect the quality of their sperm and sometimes agreed it is important to consume a healthy preconception diet and to be physically active to achieve a healthy weight before conception. 3) For many males, there was a tendency to direct a greater level of responsibility to the female than to themselves regarding preconception health. African American males can feel marginalised. CONCLUSION: Males do not always opt for a preconception consultation and many believe they are adequately prepared for a healthy pregnancy. Further, many males place a greater level of responsibility for planning and preparing for pregnancy on their partners rather than themselves. Further research focused upon male experiences and perspectives around preconception health is needed to inform targeted preconception health education, policy and care.