JSMC-10392

THE EFFECT OF RAMADAN FASTING ON PREGNANCY OUTCOMES DURING THE SECOND AND THIRD TRIMESTER

Huda Muhaddein Muhammad a , Gona Aziz Rahim b, and Roshna Ali Muhammad b

a Department of Gynaecology and Obstetrics College of Medicine, University of Sulaimani. Kurdistan Region, Iraq

b Maternity Teaching Hospital in Sulaymaniyah, Kurdistan region, Iraq. 

Submitted: 1/7/2022; Accepted: 5/1/2023; Published: 21/3/2023

DOI Link: https://doi.org/10.17656/jsmc.10392 

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ABSTRACT

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

KEYWORDS

 Ramadan fasting, Pregnancy, Paternal outcome, Neonatal outcome.

References 

1. Safari K, Piro T J, Ahmad H M. Perspective and pregnancy outcomes of maternal Ramadan fasting in the second trimester of pregnancy. BMC pregnancy and childbirth.2019;19:128.

2. Savitri A I, Amelia D, Painter R C, Baharuddin M, Roseboom T J, Grobbee D E et al. Ramadan during pregnancy and birth weight of newborns. Journal of nutritional science.2018;7(5):1-9.

3. Lily A, Bilsen V, Savitri A I, Amelia D, Baharuddin M, Grobbee D E et al. Predictors of Ramadan fasting during pregnancy. Journal of Epidemiology and Global Health.2017;6(4):267-75.

4. Al Ketbi L M B, Niglekerke N J D, Al Deen S M Z, Mirghani H. Diet restriction in Ramadan and the effect of fasting on glucose levels in pregnancy.2014;7:392.

5. Glazier J D, Hayes D J L, Hussain S, D’Souza S W, Whitcombe J, Heazell A E P et al. The effect of Ramadan fasting during pregnancy outcomes: a systematic review and meta-analysis. BMC pregnancy and childbirth.2018;18:421. 

6. Gur E B, Turan G A, Ince O, Karadeniz M, Tatar S, kasap E et al. Effect of Ramadan fasting on metabolic markers, dietary intake and abdominal fat distribution in pregnancy. HIPPOKRATIA.2015;19(4):298-303.

7. Parveen R, Khakwani M, Latif M, Tareen A U Maternal and Perinatal outcome after Ramadan fasting. Pak J Med Sci. July-A 2020;36(5):894-8.

8. Ziaee V, Kihanidoost Z, Younesian M, Akhavirad M B, Bateni F, Kazemianfar Z et al. The effect of Ramadan fasting on outcome of pregnancy. Iran J Pediatr. Jun 2010;20(2):181-6.

9. Sultan I E, Taha I M, hassanein M M. Ramadan fasting and maternal perspectives in healthy pregnant women: Systematic review. British J of Medicine & Med Research. Jan 2015;6(6):573-86.

10. Joosoph J, Abu J, Yu S L. A survey of fasting during pregnancy, Singap Med J.2004;45(12):583-6.

11. Ghazal K, Khazaal J, Chahine R, Hajjar C, Hasan J E, Naser L et al. Ramadan fasting during pregnancy: characteristics and outcomes. Int J of Reprod, Contracept, Obestet and Gynecol. Oct 2020;9(10):3936-43.

12. Karateke A, kaplanoglu M, Avci F, Kurt R K, Baloglu A. The effect of Ramadan fasting on fetal development. Pak J Med Sci.2015;31(6):1295-9.

13. Dikesoy E, Balat O, Cebesoy B, Ozkur A, Cicek H, Can G. Effect of fasting during Ramadan on fetal development and maternal health. J Obstet Gynecol Res. Aug 2008;34(4):494-8.

14. Hossain N, Samuel M, Mughal S, Shafique K. Ramadan fasting: perception and maternal outcomes during pregnancy. Pak J Med Sci.2021;37(5):1262-7.

15. Almond D, Mazumder B. The effects of maternal fasting during Ramadan on birth and adult outcomes. NBER. Oct 2008;11(112):14428.

16. Sakar MN, Gultekin H, Demir B, Bakir VL, Balsak D, Vuruskan E et al. Ramadan fasting and pregnancy: implications for fetal development in summer season. J Per Med.2015;43(3):319-23.

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