Effect of the Number of Ramadan Fasting Days on Maternal and Neonatal Outcomes

Document Type : Research Paper

Authors

1 Associate Professor in Neonatology, Neonatal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 MD, PhD Candidate for Clinical Nutrition, Biochemistry and Nutrition Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Bachelor of Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: Gynecologists and perinatologists are left with many unanswered questions and concerns regarding fasting during pregnancy and its effects on maternal and neonatal health. The current study was conducted to investigate the correlation between the number of Ramadan fasting days and pregnancy outcomes. Methods: In this descriptive, analytical study, 641 newborns, whose mothers had fasting experience during pregnancy, were enrolled and allocated to three groups, based on the number of maternal fasting days during pregnancy (group A: ≤10 days, group B: 11-20 days, and group C: 21-30 days). Demographic and anthropometric data of neonates and mothers were recorded. Descriptive statistics, Chi-square, and non-parametric tests were performed for data analysis. Results: No statistically significant difference was found in maternal weight (during the last month of pregnancy), neonatal height, incidence of pre-term labor, or neonatal congenital abnormality in the three groups. Increased number of fasting days was not correlated with decreased neonatal head circumference or weight, while 1- and 5-minute Apgar scores significantly improved (P<0.05). Conclusion: As the current findings indicated, with increasing number of fasting days, neonatal birth weight or maternal weight did not decrease. In addition, incidence of pre-term labor and low birth weight did not increase, while significant improvements were detected in 1- and 5-minute Apgar scores. Since pregnancy is a delicate state for women, further research on larger populations is recommended to evaluate other parameters and obtain more convincing results about the effects of Ramadan fasting on pregnant women.

Keywords


  1. Kavehmanesh Z, Abolghasemi H. Maternal Ramadan Fasting and Neonatal Health. Journal of Perinatology 2004;24:748-750.
  2. Boskabadi H, Ayati S, Zakerihamidi M, Mohebbi T. Fasting and Pregnancy Outcomes. IJOGI 2013;16(57):1-6.
  3. Rahbar N. The effects of fasting on serum and urine biochemical parameters and birth weight in neonates of mothers with fasting experience during pregnancy. Tabibe Shargh;2004:7(3):171-77.
  4. Abasalizadeh S. pregnancy, lactation and fasting. Journal of Tabriz University of Medical Sciences .1998;72-69.
  5. Khameneh S. An overview on physiologic adaptation of fasting and energy economics. Journal of Tabriz University of Medical Sciences. 1998;147-153.
  6. Hobel C, Culhane J. Role of psychosocial and nutritional stress on poor pregnancy outcome. J NBatr 2003; 133(5):51-6.
  7. Siega-Riz AM, Herrmann TS, Savitz DA, Thorp JM. Frequency of Eating During Pregnancy and Its Effect on Preterm Delivery. American Journal of Epidemiology .2001;153,(7):647-52.
  8. Herrmann T, Siega-Riz AM, Hobel CJ, Aurora C, Dunkel-Schetter C. Prolonged periods without food intake during pregnancy increase risk for elevated maternal corticotropin-releasing hormone concentrations. Am J Obstet Gynecol 2001;185(2):403-12.
  9. Cross JH, Eminson J, Wharton BA. Ramadan and birth weight at full term in Asian Moslem pregnant women in Birmingham. Arch Dis Child 1990;65:1053-6.
  10. Hefni M, Fikry SAH, Abdalazim M, Abdelkhalik MA. Fasting in Ramadan and preterm labour. Saudi Med J 1993;14(2):130-132.
  11. Boskabadi H, Mohebbi T. Relationship of fasting pregnant mothers and newborn growth parameters.MJMS.2014;57(3) ;57(3):526-32.
  12. Robinson T, Raisler J. "Each one is a doctor for herself": Ramadhan fasting among pregnant Muslim women in the United States. Ethn Dis 2005;15(1 Suppl 1):S1-99-S1-103.
  13. Radnia Naid, Arab Malihe, Nasrelahi Shahla. The Effect of Ramadan Fasting on Preterm Labor. Iranian Journal of Obstetrics, Gynecology and infertility fall-winter. 2005; 8(2):51-56.
  14. Danesh A. Study the effects of fasting on perinatal care in Shahre-kord. Journal of Shahre-kord University of Medical Sciences. 2002;5(4):49-54.
  15. Takruri, Hamed R. Effect of fasting in Ramadan on body weight. Saudi Medical Journal, 1989; 10(6):491-494.
  16. Husain, R, Duncan, MT, Cheah, SH, & Chng, SL. 1987. Effects of fasting in Ramadan on Tropical Asiatic Moslems. British Journal of Nutrition, 5833(1):41-48.
  17. Adlouni, A, Ghalim, N, Sale, R, Had, N, & H Parra and A Bensliman. 1998. Beneficial effect on serum apo AI, apo B and Lp AI levels of Ramadan fasting. Clinica Chimica Acta, 271(2), 179-89.
  18. Mehrmanesh M. Comparison between fasting and non-fasting pregnant women in weight gain during pregnancy. Ghoran and Teb National Conference 2007.
  19. Azizi Fereidoun. Islamic Fasting and Health, Nutrition and Metabolism April 24,2010;273.
  20. Salleh H. Ramadan Fasting among Pregnant Women in Muar District Malaysia and its Association to health outcomes. Malays J Report Health.1989;7(1):69-83.
  21. Sharbaf Fateme, Voldan Mehrnaz. Relationship of fasting in the first trimester and birth weight. Journal of Medicine Tehran University of Medical Sciences.2000;63(5):380-5.
  22. Emlaee Kh, Abedsaeedi Zh. Fasting and pre-term labor. IJEM 2001;37.
  23. Koohbumi Zh. Study the correlation between fasting and pre-term labor. Journal of Kermanshah University of Medical Sciences .2000;4(3):39-43.
  24. Boskabadi H, Saghafi N, Najafi A. Comparing the Efficacy of Cefotaxime and Ampicillin on Neonatal Infection after Premature Rupture of Membranes. IJOGI.2014; 17(93(:1-8.
  25. Kaplan M, Eidelman AI, Aboulafia Y. Fasting and the precipitation of labor: The Yom Kippur effect. JAMA 1983;250:1317-1318.
  26. Ziaee V, Razaei M, Ahmadinejad Z. Changes of metabolic profile and weight during Ramadan fasting. Singapore Med J 2006;47(5):409‐14. 
  27. Rahman M, Rashid M, Basher S, et al. Improved serum HDL cholesterol profile among Bangladeshi male students during Ramadan fasting. East Mediterr Health J 2004;10(1‐2):131‐7. 
  28. Khoshdel A, Najafi M, Kheiri S, et al. Impact of maternal Ramadan fasting on growth parameters in exclusively breast‐fed infants.  Iran J Pediatr 2007;17(4):345‐72.
  29. Shahgheibi Sh, Ghadery E, Pauladi A, et al. Effects of fasting during the third trimester of pregnancy on neonatal growth indices. Ann Alquds Med. 2005;1(2):58‐62. 
  30. Naderi T, Kamyabi Z. Determheight increase in fasting and nonfasting pregnant women during Ramadan. Saudi Med J 2004;25(6):809‐10. 
  31. Arab M. Can clinical manifestations and 24 hours before breakfast calorie intake predict the ketonuria and before breakfast blood glucose level in pregnant fasting women. IJEM 1380;12.
  32. Almond D, Mazumder B. The Effects of Maternal Fasting During Ramadan on Birth and Adult Outcomes. Federal Reserve Bank of Chicago. REVISED August, 2008. WP 2007-22.
  33. Malhotra A, Scott PH, Scott J, Gee H, Wharton BA. Metabolic changes in Asian Muslim pregnant mothers observing the Ramadan fast in Britain. Br J Nutr 1989;61(3):663–72.