{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T19:07:32Z","timestamp":1787944052592,"version":"build-2784847793"},"reference-count":41,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The safety of fathers\u2019 use of antidiabetic drugs in terms of child outcomes is an important clinical question. We aimed to assess the risk of adverse birth and early childhood outcomes after fathers\u2019 use of antidiabetics prior to conception. Methods: A nationwide cohort study based on Danish health registries. The study comprised all live born singleton children in Denmark (1997 through 2018). Children were categorized according to fathers\u2019 filled prescriptions for antidiabetic drugs three months prior to conception. Exposed cohorts: children born after paternal use of insulin or non-insulin anti-hyperglycemic agents. The unexposed constituted children born by fathers not treated with antidiabetics prior to conception. We examined adverse birth outcomes (preterm birth, small for gestational age (SGA)), and adverse childhood outcomes in the first year of life (major congenital malformations (MCMs), and infections diagnosed at a hospital). Results: A total of 1,318,684 children were included. In all, 5527 children were born after paternal use of insulin, 2121 after use of non-insulin anti-hyperglycemic agents, and 1,311,036 were unexposed. After fathers\u2019 use of insulin we did not find increased risk of adverse outcomes. After fathers\u2019 use of metformin, the adjusted OR of MCMs was 1.40 (95% CI 1.11\u20131.76). After fathers\u2019 use of sulfonylureas, the adjusted OR of SGA was 1.80 (95% CI 1.11\u20132.93), and for child gastrointestinal infections the adjusted HR was 1.76 (95% CI 1.04\u20132.99). Conclusions: Fathers\u2019 use of insulin was reassuring. Metformin and sulfonylureas were associated with selected adverse outcomes. Our findings suggest an additional 14 MCMs per 1000 fathers exposed to metformin prior to conception. As there is no meaningful supporting biological rationale, these findings should be confirmed in a different population prior to clinical consequences being drawn.<\/jats:p>","DOI":"10.3390\/jcm11216595","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T10:53:52Z","timestamp":1667904832000},"page":"6595","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Adverse Birth and Child Outcomes in Children Fathered by Men Treated with Antidiabetics Prior to Conception: A Nationwide Cohort Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-3033","authenticated-orcid":false,"given":"Bente Mertz","family":"N\u00f8rg\u00e5rd","sequence":"first","affiliation":[{"name":"Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5383-5501","authenticated-orcid":false,"given":"Jens","family":"Fedder","sequence":"additional","affiliation":[{"name":"Centre of Andrology and Fertility Clinic, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7433-7656","authenticated-orcid":false,"given":"Line Riis","family":"J\u00f8lving","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0591-7187","authenticated-orcid":false,"given":"Per","family":"Damkier","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s40471-017-0098-8","article-title":"Fathers Matter: Why It\u2019s Time to Consider the Impact of Paternal Environmental Expo-sures on Children\u2019s Health","volume":"4","author":"Braun","year":"2017","journal-title":"Curr. 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