The role of paternal obesity in fetal development, pregnancy complications, and childhood outcomes: a systematic review.

The Developmental Origins of Health and Disease theory proposes that environmental influences during early life have long-term effects on health outcomes. Although maternal factors have been extensively studied, the impact of paternal obesity on fetal development and pregnancy outcomes has received limited attention. This systematic review aimed to evaluate the effects of paternal obesity on fetal development and pregnancy complications within the DOHaD framework. English-language studies published between 2020 and 2025 were searched in PubMed, Scopus, Web of Science, and the Cochrane Library databases. Studies were selected according to the PICOS criteria, and methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. The study selection process followed PRISMA 2020 guidelines, and the protocol was prospectively registered in PROSPERO. A total of sevenprimary studies met the inclusion criteria and were included in the final review. Paternal overweight and obesity were associated with increased risks of macrosomia, large-for-gestational-age infants, low birth weight, preterm birth, preeclampsia, and cesarean delivery. In addition, paternal obesity was found to be potentially associated with childhood obesity and neurodevelopmental disorders. However, the effect of paternal body mass index (BMI) on birth weight was more limited compared to maternal factors. Paternal obesity represents a significant risk factor for fetal development and pregnancy outcomes and should be considered in preconception care strategies.