Predictors of Ramadan fasting during pregnancy

Abstract

Although the health effects of Ramadan fasting during pregnancy are still unclear, it is important to identify the predictors and motivational factors involved in women's decision to observe the fast. We investigated these factors in a cross sectional study of 187 pregnant Muslim women who attended antenatal care visits in the Budi Kemuliaan Hospital, Jakarta, Indonesia. The odds of adherence to fasting were reduced by 4% for every week increase in gestational age during Ramadan [odds ratio (OR) 0.96; 95% confidence interval (CI) 0.92, 1.00; p=0.06] and increased by 10% for every one unit increase of women's prepregnancy body mass index (BMI) (OR 1.10; 95% CI 0.99, 1.23; p=0.08). Nonparticipation was associated with opposition from husbands (OR 0.34; 95% CI 0.14, 0.82; p=0.02) and with women's fear of possible adverse effects of fasting on their own or the baby's health (OR 0.47; 95% CI 0.22, 1.01; p=0.05 and OR 0.43; 95% CI 0.21, 0.89; p=0.02, respectively), although they were attenuated in multivariable analysis. Neither age, income, education, employment, parity, experience of morning sickness, nor fasting during pregnancy outside of Ramadan determined fasting during pregnancy. Linear regression analysis within women who fasted showed that the number of days fasted were inversely associated with women's gestational age, fear of possible adverse effects of fasting on their own or the fetal health, and with opposition from husbands. In conclusion, earlier gestational age during Ramadan, husband's opinion and possibly higher prepregnancy BMI, influence women's adherence to Ramadan fasting during pregnancy. Fear of adverse health effects of Ramadan fasting is common in both fasting and non-fasting pregnant women.

Ramadan fasting during pregnancy: characteristics and outcomes

“…To our knowledge, this is one of the first studies that examined the characteristics and outcomes of Ramadan fasting in pregnant women over a period of 10 years since most of the studies were conducted over one or few years. 5,8,[10][11][12][13][14][15] The rate of fasting in the current study (84.9%) was similar to the rate of a study conducted in Pakistan (82.8%) and another in Indonesia (80%). 5,13 Other studies showed a lower prevalence of fasting.…”

“…11,16 However, the Netherland and Indonesian studies reported that parity did not affect adherence to fasting. 5,6 Moreover, the proportions of fasting women during pregnancy significantly differed across nationality in the current study since non-Lebanese (Syrians and Palestinians) fasted more than Lebanese (92.2% versus 83% respectively). Likewise, the findings in Netherlands showed that ethnicity affected fasting since the percentage of fasting was 78.9% in Moroccan, 21.7% in Turkish and 40% in other nationalities.…”

“…Likewise, the study in Indonesia showed that neither age, education nor employment affected fasting during pregnancy. 5 On the contrary, the studies by Leimer et al and Najimudeen concluded that younger women and those with low education level had a higher tendency to fast. 2,15 The Bradford study reported that maternal employment was not significantly associated with fasting whereas women who had higher educational qualifications were less likely to fast as were older mothers compared to younger ones.…”

“…Additionally, higher adherence to fasting was among women who were in the first or second trimester as compared to the third trimester. 5,6,11 This could be due to the lower burden of pregnancy during the first trimester of pregnancy or because women were still unaware about their pregnancy. 17 The present study showed no significant difference in terms of maternal fasting and season or month since the proportion of those who fasted was similar in the spring and summer.…”

“…4 Moreover, women in the first trimester had higher adherence to fasting than those in the second or third trimester. 5 Thus, fasting during pregnancy is considered debatable. Several studies examined the effect of fasting on pregnancy outcomes.…”