The impact of alcohol use by biological fathers prior to pregnancy on the health of their offspring is a rapidly growing field of medical research and the subject of active discussion within the FASD field and the FASD community.
The latest research, from scientists at Texas A&M University, indicates that paternal preconception alcohol exposure (PPAE) can impact a child’s physical, cognitive, and behavioral development, with potential lifelong implications. This challenges the widely held view that only maternal alcohol use during pregnancy is a serious concern. As the health impacts of paternal exposure continue to be studied, this topic is likely to gain increased public awareness, consideration, and discussion.
Much of the ongoing medical research on PPAE is preclinical, conducted using animal models, and is in its early stages, with more robust findings and clear conclusions on outcomes in people likely to be drawn in the coming years. Still, current research indicates that PPAE, or alcohol use by fathers prior to their partner’s pregnancy, is associated with impacts on the long-term health outcomes of their children. This raises significant questions and issues when it comes to the discussion of FASD, with major implications on the broader issues around pregnancy, alcohol, and public health.
A key takeaway: Both biological parents share responsibility for the health of their pregnancy
The latest evidence reinforces our understanding that men and fathers share responsibility for a healthy pregnancy with their pregnant partners. Ongoing research shows that a father’s alcohol use prior to conception impacts healthy sperm development. Studies show that these impacts can affect the long-term mental and physical health of these fathers’ offspring.
Dr. Michael Golding, a professor of biomedical science at Texas A&M who has been leading much of the research on PPAE says, “I think there’s a notion that male alcohol use does not have an impact on the offspring, and that’s completely not true.”
In addition, fathers and partners play an important role in preventing prenatal alcohol exposure by supporting their pregnant partner to abstain from alcohol throughout the pregnancy. Over two-thirds of romantic couples share in similar drinking habits, known as “congruent drinking partnerships.” Pregnant women who have a supportive partner who abstains from alcohol alongside her are more likely to abstain from alcohol, which can improve the health outcomes of both the mother and the child.
The pre-conception period offers both biological parents the opportunity to avoid alcohol, as research indicates that pre-conception maternal alcohol exposure can also impact offspring, though further details on this type of exposure are outside the scope of this article.
“It has taken a small group of pioneering researchers to show our field that paternal alcohol use matters as well as maternal alcohol exposure,” says Dr. Siara Rouzer, an incoming faculty member in the Department of Psychological and Brain Sciences at Texas A&M University.
What the latest science says about paternal alcohol exposure
The latest medical research currently indicates that alcohol alters biological and epigenetic signals in the father’s sperm. These alterations have been associated with persistent effects on offspring. As with prenatal alcohol exposure, PPAE is associated with changes to brain development and behavior. PPAE has been shown to impact cognitive development and connections in the brain. Studies have found an association between PPAE and an increased risk of developing sleep disorders, ADHD, and depression. Dr. Michael Golding points out that, “We know now, even from human clinical studies, that male alcohol use has an adverse effect on child health and development.”
In animal studies, PPAE has been linked to some of the same types of physical features that are known to occur in Fetal Alcohol Syndrome, including microcephaly (small head size), facial features, and growth impairment. We know that most people with FASD do not have any physical features, and this is likely the case as well when it comes to those impacted by PPAE.
Research also shows that PPAE is associated with physical health impacts, including heart defects. This is in line with the well-documented link between prenatal alcohol exposure and many physical health impacts, including heart defects and diabetes.
FASD and paternal alcohol exposure
The term fetal alcohol spectrum disorders (FASD) is defined as the range of health conditions that result from prenatal alcohol exposure, specifically referring to gestational or intrauterine alcohol exposure, meaning that an embryo or fetus is exposed to alcohol during the period between conception and birth.
PPAE, or alcohol exposure that occurs through the impacted sperm of the non-pregnant partner prior to conception, is not in itself a cause of FASD, as the term is defined because PPAE is not currently classified as prenatal alcohol exposure. That said, research into PPAE has some relation to research into FASD, as PPAE produces some phenotypes, or observable characteristics, that overlap with FASD.
Impacts on public health and public awareness
Major health agencies, including the CDC, National Institutes of Health, and the U.S. Surgeon General, advise that no alcohol is safe during pregnancy, along with many national health organizations. Given the emerging research on PPAE, it may be appropriate in the future for these agencies to consider amending their longstanding guidance to advise against alcohol use during pregnancy, as well as alcohol use prior to conception by biological fathers.
Increased understanding of the important roles that both biological partners play in the health of a pregnancy can lead to a more balanced and equal treatment of biological mothers and fathers. Dr. Kelly J. Huffman, Professor of Psychology at the University of California, Riverside, says, “Clearly, the paternal environment before conception is critical for healthy offspring development. Fathers who consistently consume moderate to high amounts of alcohol leading up to conception may negatively impact offspring development.”
For far too long, mothers have unfairly been regarded as solely responsible for the health of their pregnancy. Fathers are often left out of the conversation. Raising awareness of the impacts of PPAE is an opportunity to move towards a more balanced approach to pregnancy health.
Our experience with FASD shows us what can happen when the public becomes aware of a health risk. When much of the public first became aware of Fetal Alcohol Syndrome in the 1980s and 1990s, some individuals reacted with feelings of anger directed towards pregnant women who consumed alcohol. This created an atmosphere of blame and shame, which continues to be a major issue today.
We are mindful that the harmful blame and shame that birth mothers of children with FASD face could also be experienced by the biological fathers of children impacted by PPAE. This presents the FASD field with an opportunity to take steps to incorporate affirming language throughout the process of the public’s growing awareness of the health risks of PPAE.
Research is still ongoing
Medical research into PPAE is still ongoing and much remains to be known. We are years away from being able to draw conclusions about PPAE with the same degree of confidence as we currently do when it comes to prenatal alcohol exposure. Emerging research indicates that dual paternal and maternal alcohol exposure has a greater impact than either exposure by itself. Alcohol exposure by both biological parents can compound the health impacts on offspring. As Dr. Siara Rouzer points out, “I truly believe that bringing all parents into the conversation will help us move toward better diagnosis, treatment, and support.”
As we continue to learn more about the medical science of PPAE, the need for organized collaboration within the FASD field and responsive public messaging is more important than ever. The growing awareness of the father’s role in the health of their offspring is likely to have major implications in the public health field.
As the national leader in this area, FASD United is committed to making the most of this opportunity to expand the public’s awareness of the health impacts of prenatal alcohol exposure and PPAE and to advocate for improved outcomes for all those impacted by FASD.