Health and behavioural risks for adverse pregnancy and offspring outcomes across peak male fertility: Prevalence in the Australian longitudinal study on male health.

OBJECTIVES: Male preconception exposures are associated with adverse pregnancy and offspring outcomes, yet few studies have reported prevalence of these risk factors in men of reproductive age. We aimed to estimate preconception risk factor prevalence and concurrent risk counts, and to identify risk levels within population subgroups. STUDY DESIGN: Descriptive, cross-sectional analyses of a national cohort study. METHODS: Data were from four waves across the Australian Longitudinal Study on Male Health (2012-2022). Included were fertile men aged 18-44 years at each wave (nw1 = 8727; nw2 = 5854; nw3 = 3267; nw4 = 2705). Eleven pre-established risk factors were assessed: eight were available at all waves and used to derive a concurrent risk score (harmful alcohol use, cigarette use, cannabis use, illicit drug use, occupational exposure to harmful substances, type 2 diabetes, depression, and high body mass); three were assessed at between one and three waves (anxiety, intimate partner violence perpetration, and low fruit or vegetable intake). Proportions were estimated at each wave and weighted to be population representative. Subgroup differences were examined in regression analyses. RESULTS: 82-84% of men had one or more preconception risk factors, 48-53% had two or more. The most common risk was low fruit or vegetable intake (76-77%). Relative to counterparts, men under financial stress reported 45-50% more risk factors, men with lower education reported 18-30% more, unemployed men 19-32% more, and men residing in regional or remote locations 12-22% more. CONCLUSIONS: Results present compelling evidence of high preconception health needs in men and underscore the importance of supporting men prior to reproduction.