Background: The current uncertainties and alarming situation of COVID-19 pandemic may cause anxiety, mental distress and fears among pregnant women, who otherwise may have been progressing well. Till date, there is no robust empirical evidence, how the COVID-19 pandemic might have influenced the generalized anxiety and fears among pregnant women.Objective: To determine the perceptions, anxiety and fears of current COVID-19 pandemic among pregnant women during antenatal and immediate postpartum period.Setting: Pregnant women attending antenatal outpatient department, or women who recently delivered at the Department of Obstetrics & Gynecology Unit II, Ruth Pfau KM Civil Hospital and Holy Family Hospital, Karachi were included in the study.Methods: A pre-designed, validated questionnaire was used by medical doctors through a face-to-face interview to collect the desired information. Associations were determined using parametric tests and a p-value ≤ 0.05 was considered as statistically significant.Results: A total of 286 pregnant women with a mean age of 26.47 ± 4.81 years were enrolled in the study. The mean gestational age of women was 33.04 ± 7.54 weeks. Majority of women 67.8% (n=194) perceived that COVID-19 can affect the pregnancy, it can be transmitted to newborn baby 83.2% (n=238), and can affect the child if mother has infected with this virus 84.6% (n=242). Most of the women 84.6% (n=242) were afraid of COVID-19 infection, and reported mean fear level of 5.86 ± 3.12 on a scale of 1 to 10. Women who perceived that COVID-19 can affect the child had significantly higher level of GAD scores (n=37, 15.3%, p-value 0.042). Similarly, women who were afraid of COVID-19 infection had significantly higher (n=40, 16.5%, p-value 0.046) GAD score. Women who had high GAD score (≥7) also had significantly higher (p-value 0.020) fear score (6.90 ± 3.23 vs 5.68 ± 3.07) compared with women who had normal GAD score (<7).Conclusion: High proportion of women had stronger belief that if mother have infection, child will also have it and it’s likely to be transmitted from mother to child. Although there is not enough evidence to support vertical transmission of infection as yet but it is still appearing as a major stressor among pregnant women.

Objectives: To see perception and knowledge of women about Ramadan fasting and maternal effects of fasting. Methods: The study design was prospective, case-controlled. This study was conducted at Holy Family Hospital from 1st May 2020 to July 2020. Pregnant women with spontaneous conception and singleton pregnancies, who fasted for seven or more days, were cases, and those who did not fast were taken as controls. Questionnaire was filled regarding perception of women about maternal fasting. Primary maternal outcomes included preterm delivery, pregnancy induced hypertension, and gestational diabetes mellitus. The analysis was conducted using Statistical Package for Social Sciences version 16.0. Results: A total of 215 women were included in the study, 123 women fasted, and 92 women did not fast. Only 2.8% of women knew that fasting is forbidden in pregnancy. Sixty five percent of women reported weakness as the main reason for not fasting. The rate of gestational diabetes, pregnancy induced hypertension and preterm delivery was higher among women who fasted (17% vs 14%, 7% vs 2%, 9% vs 9%) respectively, compared to non-fasting women, but were not found statistically significant. There was no difference in anthropometric measurements of newborn, among both groups. Conclusion: Ramadan fasting does not affect maternal outcomes during pregnancy. doi: https://doi.org/10.12669/pjms.37.5.4109 How to cite this:Hossain N, Samuel M, Mughal S, Shafique K. Ramadan Fasting: Perception and maternal outcomes during Pregnancy. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4109 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To compare maternal and perinatal outcome of Ramadan fasting during pregnancy in women with/without gestational diabetes. Methods: This prospective case-control study was conducted at Department of Obstetrics & Gynecology Unit 1 Ruth PKM Civil Hospital & Dow Medical College and Holy Family Hospital, Karachi during 1st April to 31st July, 2022. In this study normoglycemic pregnant women and those identified as gestational diabetes(n=52) on oral glucose tolerance test, who fasted during Ramadan were included. Women, on diet control or diet plus metformin were included in the study. Study questionnaire included demographic details, days of fasting, self-reported hypoglycemic episodes. Maternal outcomes included preterm birth, pregnancy induced hypertension. Perinatal outcome included hyperbilirubinemia, hypoglycemia, weight of placenta, and apgar score. Result: Eighty two women were included in the study, gestational diabetes (n=57) and normoglycemic (n=25). Average days of fasting were 16 ±9.0 days (range 5-30). Women with GDM were older (28.6 vs. 26.0 years, p-value=0.034), had raised levels of HbA1c (5.5 vs. 5.1, p-value=0.004), mean FBS (102.8 vs. 84.6 mg/dl, p-value <0.001), mean RBS (135.3 vs. 106.4 mg/dl, p-value <0.001) and had higher BMI at delivery (31.0 vs. 26.6 kg/m2, p-value=0.004). HbA1c (p-value=0.016) and head circumference of baby (p-value=0.038) were found lower in the group who fasted for more than 20 days among normoglycemic pregnant women. No other maternal and neonatal outcomes were found to be significantly affected by Ramadan fasting among pregnant women with/without GDM. Conclusion: Gestational diabetes do not affect maternal and perinatal outcome among pregnant women. doi: https://doi.org/10.12669/pjms.39.2.7332 How to cite this: Abdullah S, Shumaila, Mughal S, Samuel M, Hossain N. Maternal and perinatal outcome of Ramadan fasting in women with gestational diabetes. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.7332 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.