Preconceptional paternal obesity may increase the risk of congenital urogenital anomalies in offspring: A case-control study.

BACKGROUND: Congenital urogenital anomalies affect 4-60 per 10,000 births. Maternal obesity, along with other risk factors, is well documented as a contributing factor. However, the impact of paternal obesity on risk is unclear. Obesity is prevalent among men of reproductive age, highlighting the need for further research into the potential association between paternal obesity and offspring congenital urogenital anomalies. OBJECTIVES: This study aims to determine the association between paternal obesity and the risk of congenital urogenital malformations in offspring. METHODS: Case-control study conducted on 179 newborns (91 cases, 88 controls) selected from the Notre Dame des Secours-university hospital database. Cases were identified as newborns presenting at least one congenital urogenital abnormality, defined as developmental anomalies that can result in a variety of malformations affecting the kidneys, ureters, bladder, and urethra. Controls were identified as newborns without any congenital abnormalities. The exclusion criteria were maternal obesity, infections during pregnancy, chronic diseases, prematurity, growth retardation, assisted reproductive technologies for conception, substance abuse, down syndrome, and other malformations. Data were collected through phone interviews, medical records, and questionnaires. In this study, the exposure was the preconceptional paternal body mass index (BMI), which was calculated based on self-reported height and weight. According to guidelines from the US Centers for Disease Control and Prevention (CDC), individuals are considered to be in the healthy weight range if their BMI (kg/m2) is between 18.5 and < 25. They are classified as overweight if their BMI is ≥ 25, obese class I if their BMI is between 30 and < 35, obese class II if their BMI is between 35 and < 40, and obese class III if their BMI is 40 or higher. Logistic regression analysis was employed to quantify the association between paternal obesity and urogenital conditions in offspring. RESULTS: Significant differences in median (minimum-maximum) paternal BMI values were noted between the cases and controls at the time of conception (cases: 27.7 (43-20.1), controls: 24.8 (40.7-19.6); p < 0.0001). Logistic regression analysis confirmed that at the time of conception, compared to normal-weight fathers, overweight fathers displayed a heightened risk of offspring congenital malformations, with an odds ratio (OR) of 4.44 (95% CI = 2.1-9.1). Similarly, fathers categorized as obese Class I at conception had approximately eight times higher odds (OR = 8.62, 95% CI = 2.91-25.52) of having offspring with urogenital conditions compared to normal-weight fathers. Additionally, fathers classified as obese Class II at conception exhibited 5.75 times higher odds (OR = 5.75, 95% CI = 0.96-34.44) of having offspring with urogenital conditions in comparison to normal-weight fathers. DISCUSSION AND CONCLUSION: We found that the risk of urogenital malformations increased with paternal BMI during the preconceptional period. The findings suggest the importance of addressing paternal obesity in efforts to reduce the risk of urogenital congenital malformations in offspring.

Paternal peri-conceptional physical activity and the risk of congenital heart disease in offspring: A case-control study.

BACKGROUND: Genetic and environmental factors have been shown to contribute to the development of congenital heart disease (CHD). To date, the focus of scientific articles has primarily centered on genetics and maternal environmental factors, with comparatively less attention given to paternal risk factors. OBJECTIVES: This study aims to investigate the potential association between paternal pre-conceptional physical activity levels (PA), along with paternal peri-conceptional smoking and alcohol consumption, and the risk of CHD in offspring. MATERIALS AND METHODS: An observational case-control study was conducted in Lebanon, with 279 participants, aiming to investigate potential risk factors for CHD. We included children with confirmed CHD, born between 2012 and 2022. Controls born in the same timeframe were selected randomly from the general population using online questionnaire forms. Mean age of children included was 6 years old (0-10). The pre-conceptional PA was assessed using the Global Physical Activity Questionnaire validated in Arabic. In addition, paternal smoking, alcohol consumption, and maternal risk factors were collected. RESULTS: The study included 128 CHD cases (45.9%) and their parents, as well as 151 healthy infants (54.1%) and their parents. There were no statistically significant variations in the alcohol consumption noted between the fathers in the case and control groups (p = 0.18). The paternal involvement in recreational-related PA during the peri-conception period was associated with a reduced risk of the CHD development in offspring by 46.9% (OR = 0.531, 95% CI: 0.301-0.936, p = 0.029). Additionally, increasing paternal total sitting time by 1 h above the average, which was approximately 260 min (4 h), increased the risk of CHD in offspring by 0.4% (p = 0.001). Moreover, paternal smoking exhibited an apparent association with a 56% increased risk of offspring developing CHD, notwithstanding that the confidence intervals included the null (OR = 1.56, 95% CI: 0.86-2.8, p = 0.136). DISCUSSION AND CONCLUSION: This observational study is the first to report a potential association between paternal PA, and CHD in offspring. This study aligns with previous reports, advocating for the paternal engagement in PA and the adoption of healthy lifestyle habits, especially during the critical stages of conception. Such practices are strongly recommended to enhance fertility and promote optimal health for offspring. However, due to the subjectivity in reporting PA and lack of molecular proof, additional prospective and molecular studies are required to validate these findings.

Work fatigue among Lebanese physicians and students during the COVID-19 pandemic: validation of the 3D-Work Fatigue Inventory (3D-WFI) and correlates.

BACKGROUND: Work fatigue is a work-related condition that affects physicians' health, work attitude safety and performance. Work fatigue affects not only medical workers but can also leave a negative impact on patients. With the burden of the COVID-19 pandemic as well as the economic crisis Lebanese doctors have been facing in the last 2 years, the aim of our study was to validate the 3D-Work Fatigue Inventory (3D-WFI) among Lebanese physicians and assess the rate and correlates of work fatigue (physical, mental and emotional). METHODS: A cross-sectional study was undertaken through an anonymous self-administered questionnaire between October 2020 and January 2021. The SPSS AMOS software v.24 was used to conduct confirmatory factor analysis (CFA). To validate the 3D-WFI, multiple indices of goodness-of-fit were described: the Relative Chi-square (χ2/df) (cut-off values:< 2-5), the Root Mean Square Error of Approximation (RMSEA) (close and acceptable fit are considered for values < 0.05 and < 0.11 respectively), the Tucker Lewis Index (TLI) and the Comparative Fit Index (CFI) (acceptable values are ≥0.90). RESULTS: A total of 401 responses was collected; 66.1, 64.8 and 65.1% respondents had an intermediate to high level of emotional, mental and physical work fatigue respectively. The fit indices obtained in the CFA of the 3D-WFI items fitted well: CFI =0.98, TLI =0.98, RMSEA = 0.05; 95% CI 0.046-0.063; pclose = 0.20) and χ2(136) = 295.76. The correlation coefficients between the three factors (Factor 1 = Physical work fatigue, Factor 2 = Mental work fatigue, Factor 3 = Emotional work fatigue) were adequate as well: Factor 1-Factor 2 (r = 0.70), Factor 1-Factor 3 (r = 0.52) and Factor 2-Factor 3 (r = 0.65). In addition, feeling pressured by long working hours during the pandemic, having more hours of night duty per month, more stressful events in life, and higher depression were significantly associated with more physical and mental work fatigue. Higher depression and having more stressful events in life were significantly associated with more emotional work fatigue. CONCLUSION: Work fatigue in Lebanese physicians seems to be associated with higher level of everyday stress, high work load and depression. Hospitals and local health authorities can use these results for early interventions that aim to reduce work fatigue and ensure the wellbeing of Lebanese physicians.

Aeroallergen sensitization in Lebanese asthmatic children: the results of a cohort national study.

Atopic asthma is characterized by the presence of sensitization to common aeroallergens, which tends to have a worse prognosis than non-atopic asthma. The objectives were to determine the prevalence of aeroallergens sensitization in the Lebanese pediatric asthmatic population and determine the relationship between allergens sensitization (indoor and outdoor) and age, area of residence and altitude. A sample, consisting of 919 asthmatic children (aged 1 to 18 years, from 2010 until 2017), underwent skin prick testing (SPT) with 21 common allergens: 5 grasses (cocksfoot, sweet vernal-grass, rye-grass, meadow grass, timothy), Parietaria, olive, Dermatophagoides pteronyssinus and Dermatophagoides farina (DP-DF), dog and cat dander, Alternaria longipens, Aspergillus fumigatus and nidulans, Cupressaceae, pine, German cockroach, and 4 cereals (oat, wheat, barley, maize). Seven hundred fifty-two patients had positive SPT. The distribution of sensitization was as follows: DP-DF 59%; 5 grasses 34%; 4 cereals 33.9%; cat 29.9%; Alternaria 27.9%; Parietaria 23%; dog 21.9%; olive 20.5%; Aspergillus mix 18.6%; Cupressaceae 18.2%; pine 17%; cockroach 15.3%. House dust mites sensitization was frequent at lower altitude (< 900 m) (56.3%) and in the whole country (a median prevalence of 53.05%) except for the Beqaa region (negative HDM in 82.4%). Non-atopic asthma was more frequent in early childhood (40.5% at 1-4 years vs 11.2% at 11-18 years). The sensitization rate increased with age, starting at 5 years. Higher age (aOR = 1.24) and altitude less than 900 m compared with ≥ 900 m (aOR = 2.03) were significantly associated with the presence of aeroallergens in children. House dust mites and grasses are the most common allergens in Lebanese asthmatic children. Non-atopic asthma is more frequent at early age. Lebanese children with asthma showed a polysensitized pattern starting at 5 years.