Paternal Influences on Offspring Bone, Muscle and Growth in Childhood and Adulthood: A Systematic Review

Objective There is a growing body of evidence examining the paternal origins of health and disease. This review aimed to systematically search extant literature regarding the relationship between paternal lifestyle and health exposures during early life, conception or pregnancy and offspring childhood and adulthood musculoskeletal, body composition and growth measures. Data Sources The MEDLINE, Embase, CINAHL and Cochrane Library electronic databases were searched using both subject headings and free‐text terms for the fathers’ exposures and offspring outcomes. All published literature in the English language from each database's inception through to October 2024 was queried. Forward and backwards citation screening of all relevant articles was conducted. Study Eligibility Criteria Experimental and observational studies assessing any paternal exposure during early life, peri/conception or pregnancy, and their association with offspring growth and musculoskeletal health measures in infancy, childhood and adulthood were included. For the purpose of this paper, only papers featuring offspring measures in childhood and adulthood have been discussed. Study Appraisal and Synthesis Methods The extracted data were primarily descriptive and included information on the study design, sample size, paternal exposure, offspring outcome, timeframe of offspring outcome measurement, major findings and the confounding variables included in statistical models. Risk of bias was assessed using the Newcastle–Ottawa tool. The studies were characterised based on the outcome assessed. This study was registered with the International Prospective Register of Systematic Reviews. Results In total, 290 papers met the inclusion criteria of the review, of which 118 reported on offspring outcomes during childhood and adulthood. Some paternal exposures appear to have an association with musculoskeletal and growth measures in offspring during childhood and adulthood. However, there is limited evidence and contradictory findings for many reported paternal exposures. Conclusions This systematic review indicates that some paternal exposures, such as body mass index and smoking, appear to have an association with offspring childhood and adulthood musculoskeletal and growth measures. Further research is required to determine if there are associations with other paternal exposures and whether the reported associations hold true in larger, more robust studies.