Ramadan fasting during pregnancy: characteristics and outcomes

Ghazal, Kariman; Khazaal, Janoub; Chahine, Rabih; Hajjar, Charlotte; Hasan, Jihad El; Naser, Liliane; Koulaymi, Eva; Yared, Georges

doi:10.18203/2320-1770.ijrcog20204275

Cited by 4 publications

(7 citation statements)

References 16 publications

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“…The change in the Hb level, random blood glucose, and blood pressure after Ramadan were not significantly different between the two groups, which is going with results conducted by Ghazal K et al, Parveen R et al, and Hossain N et al (7,11,14) .…”

Section: Discussionsupporting

confidence: 88%

“…Regarding the mean age and mean weight (at the beginning of Ramadan) of pregnant ladies, there was no significant difference between the two groups; this goes with the studies done by Safari K et al, Parveen R et al, Ziaee V et al, Ghazal K et al, Karateke A et al (1,7,8,11,12) . 90 (66.6%) of pregnant women from urban areas were fasting, and 53 (62%) from rural areas were not.…”

Section: Discussionsupporting

confidence: 80%

“…90 (66.6%) of pregnant women from urban areas were fasting, and 53 (62%) from rural areas were not. Although the difference between the two areas was insignificant, fasting was more in urban areas; it is not going with a study done by Ghazal K et al (11) , in which all cases from the rural area were fasting compared to 85% from urban areas. This may be because of geographical variation between the two studies that may affect weather and the kind of work these women do in that holey month.…”

Section: Discussionmentioning

confidence: 70%

“…While it is not going with studies done by Safari K et al, and Parveen R et al (1,7,11) , as fasting was less in employed pregnant women, this may be explained because Ramadan was in hot weather in their countries and cities.…”

Section: Discussionmentioning

confidence: 84%

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The Effect of Ramadan Fasting on Pregnancy Outcomes During the Second and Third Trimester

Muhammad,

Rahim,

Muhammad

2023

JSMC

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Background Fasting during pregnancy has always been considered a debatable condition. Some Muslim women do not fast during pregnancy for their children’s health; however, they feel uncomfortable because of their religious beliefs. On the other hand, some pregnant mothers prefer to fast despite their anxiety about their children’s health, and they fast during pregnancy. Objectives To evaluate Ramadan fasting effects in the second and third trimesters of pregnancy on maternal health, fetal growth and early neonatal outcome. Patients and Methods An observational case-control study carried out in Sulaymaniyah City/Kurdistan region/Iraq within a period between April to October 2021, involving 220 healthy pregnant women presented one week before and within the first week of Ramadan in their second or third trimester of pregnancy, they are grouped into two groups (fasting and non-fasting) according to their choice. Both groups followed 4-8 weeks after the first visit and at the delivery time. The parameters observed in the first and second visits were maternal age, weight, residency, maternal job, maternal blood pressure, haemoglobin (Hb), random blood glucose (RBS), gestational age measured by ultrasound, amniotic fluid index (AFI), fetal growth measured by ultrasound. The mode of delivery with an indication of cesarean section(C/S) was recorded in addition to the above parameters at the time of delivery. In addition, birth weight and 5 minutes APGAR score were also recorded. Results Of 220 women, 77 were not fasting, and 143 were fasting. About 87 women presented in the second trimester (57 cases were fasting), while 133 women presented in the third trimester (86 cases were fasting), and no significant changes in the evaluated parameters were observed. There was no significant difference between the fasting and non-fasting groups. Three babies from the fasting group were delivered during the preterm period, while two were delivered preterm in the non-fasting group. This study recorded neither intrauterine fetal death (IUFD) nor stillbirth. No significant difference in APGAR scores at 5 minutes and birth weight was observed between the two groups. Conclusion Ramadan fasting does not increase the risk of maternal, fetal and early neonatal complications. Most Muslim pregnant women do not recognize their right to be excused from fasting Ramadan by the Islamic religion, and they have a high rate of fasting with very strong desire and happiness.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 84%

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The Effect of Ramadan Fasting on Pregnancy Outcomes During the Second and Third Trimester

Muhammad,

Rahim,

Muhammad

2023

JSMC

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“…In contrast, the effects of Ramadan on the unborn child are less explored. Even though Islamic law gives permission for pregnant women to opt out of fasting, it is common that expectant mothers follow Ramadan fasting due to different reasons, such as to improve their spiritual activity [7], as well as due to influence from partners and families [8,9]. It is widely perceived that the early phase of pregnancy, when organogenesis takes place, is crucial for human development [10].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of in Utero Ramadan Exposure: A Systematic Literature Review

et al. 2021

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Health outcomes of in utero Ramadan exposure have been reported in a systematic literature review; however, the available literature on long-term effects were not fully covered. Our study aims to specifically review the long-term outcomes of in utero Ramadan exposure. We searched for original research articles analyzing any long-term outcome of in utero Ramadan exposure, excluding maternal and perinatal outcomes. Sixteen studies from 8304 non-duplicate search results were included. Most studies suggest negative consequences from in utero Ramadan exposure on health, as well as on economic outcomes later in adulthood. Higher under-five mortality rate, higher mortality under three months, and under one year, shorter stature, lower body mass index, increased incidence of vision, hearing and learning disabilities, lower mathematics, writing and reading scores, as well as a lower probability to own a home were associated with Ramadan exposure during conception or the first trimester of pregnancy. Furthermore, age and sex seem to play a pivotal role on the association. Existing studies suggest that in utero Ramadan exposure may adversely impact long-term health and economic well-being. However, evidence is limited. Meanwhile, increasing awareness of the potential risks of Ramadan fasting during pregnancy should be raised among pregnant women and clinicians and other antenatal care workers should promote better maternal healthcare.

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Ramadan during pregnancy and offspring health outcomes over the life course: a systematic review and meta-analysis

Pradella,

Witte,

van Ewijk

2024

Human Reproduction Update

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BACKGROUND Intermittent fasting, such as during Ramadan, is prevalent among pregnant women. However, the association between Ramadan during pregnancy and offspring health along the life course has not been fully established. OBJECTIVE AND RATIONALE Fetal programming research indicates that prenatal exposures, particularly during early pregnancy, can cause long-term structural and physiological changes that adversely affect offspring health. Our objective was to systematically identify and assess the evidence regarding Ramadan during pregnancy. SEARCH METHODS A total of 31 studies were sourced from PubMed, EMBASE, Web of Science, and EconLit. Included studies evaluated outcomes in individuals with prenatal Ramadan exposure, compared to unexposed Muslim controls. Main outcomes were birth weight, gestational length, and sex ratio in newborns; height, mortality, and cognition in children; and disabilities, chronic diseases, and human capital accumulation in adults. Each study was evaluated for risk of bias. The overall quality of evidence was appraised using the GRADE system. Random-effects meta-analyses were conducted for outcomes analyzed in at least three primary studies. OUTCOMES The initial search identified 2933 articles, 1208 duplicates were deleted. There were 31 publications fulfilled the eligibility criteria for the qualitative synthesis; 22 studies were included in meta-analyses. The overall quality of the evidence was low to moderate and differed by study design and outcome. Among newborns, prenatal Ramadan exposure was not associated with birth weight (mean difference (MD) −3 g (95% CI −18 to 11; I2 = 70%) or the likelihood of prematurity (percentage point difference (PPD) 0.19 (95% CI −0.11 to 0.49; I2 = 0%)). The probability that the newborn is male was reduced (PPD −0.14 (95% CI −0.28 to −0.00; I2 = 0%)). This potentially reflects sex-specific mortality rates resulting from adverse in utero circumstances. In childhood, the exposed performed slightly poorer on cognitive tests (MD −3.10% of a standard deviation (95% CI −4.61 to −1.58; I2 = 51%)). Height among the exposed was reduced, and this pattern was already visible at ages below 5 years (height-for-age z-score MD −0.03 (95% CI −0.06 to −0.00; I2 = 76%)). A qualitative literature synthesis revealed that childhood mortality rates were increased in low-income contexts. In adulthood, the prenatally exposed had an increased likelihood of hearing disabilities (odds ratio 1.26 (95% CI 1.09 to 1.45; I2 = 32%)), while sight was not affected. Other impaired outcomes included chronic diseases or their symptoms, and indicators of human capital accumulation such as home ownership (qualitative literature synthesis). The first trimester emerged as a sensitive period for long-term impacts. WIDER IMPLICATIONS Despite the need for more high-quality studies to improve the certainty of the evidence, the synthesis of existing research demonstrates that Ramadan during pregnancy is associated with adverse offspring health effects in childhood and especially adulthood, despite an absence of observable effects at birth. Not all health effects may apply to all Muslim communities, which are diverse in backgrounds and behaviors. Notably, moderating factors like daytime activity levels and dietary habits outside fasting hours have hardly been considered. It is imperative for future research to address these aspects. REGISTRATION NUMBER PROSPERO (CRD42022325770).

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Ramadan fasting during pregnancy: characteristics and outcomes

Cited by 4 publications

References 16 publications

The Effect of Ramadan Fasting on Pregnancy Outcomes During the Second and Third Trimester

The Effect of Ramadan Fasting on Pregnancy Outcomes During the Second and Third Trimester

Long-Term Outcomes of in Utero Ramadan Exposure: A Systematic Literature Review

Ramadan during pregnancy and offspring health outcomes over the life course: a systematic review and meta-analysis

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