College

College of Health Sciences

Department

Health Sciences

Graduate Level

Doctoral

Graduate Program/Concentration

Health Services Research

Presentation Type

Poster Presentation

Abstract

Fasting during the holy month of Ramadan is one of the obligatory duties in Islam, which includes refraining from consuming food and drinks and engaging in sexual activity from dawn to sunset. Though pregnant women are exempted from this practice, approximately 80-90% of Muslim pregnant women choose to fast during Ramadan as part of their religious and cultural beliefs. The impact of fasting holy month of Ramadan during pregnancy on pregnancy/birth outcome remains under debate, despite several primary research studies and literature reviews. Up to date, no guidelines or recommendations have been formulated regarding fasting holy month of Ramadan for pregnant Muslim women in US or other settings. The aim of this umbrella review was to assess the current evidence on the impacts of fasting holy month of Ramadan during pregnancy on pregnancy/birth outcomes, which is a prerequisite to develop evidence-based guidelines. We systematically searched PubMed, CINAHL, Cochrane Registry of Systematic Reviews databases, and google scholar to identify systematic reviews that focused on the impact of fasting holy month of Ramadan on pregnancy/birth outcomes including birth weight (continuous), low birth weight, preterm birth, C-Section, stillbirth, small for gestational age, preeclampsia, gestational diabetes, miscarriage, ectopic pregnancy, gestational diabetes, and gestational hypertension. Of 946 records identified, 13 reviews met the inclusion criteria and were included for analysis (4 of high quality, 6 of moderate quality, and 3 of low quality as peer MOOSE 2 checklist). Our findings showed that there is currently no evidence for adverse pregnancy/birth outcomes due to fasting during pregnancy. One review showed statistically significant (p=0.03) but clinically non-significant difference in birth weight of children of mothers who fasted and those who did not. The lack of evidence could be due to several unmeasured confounding factors such as maternal age, number of days of fasting, and pregnancy trimester in which fasting occurred. There is a need for more rigorous primary research studies that control for potential confounders and include a clear definition of exposure to generate the evidence necessary to formulate evidence-based recommendations.

Keywords

Ramadan, fasting, birth outcomes, long-term child health impacts, pregnant women.

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Impacts of Fasting Holy Month of Ramadan during Pregnancy on Pregnancy/Birth Outcomes: An Umbrella Review

Fasting during the holy month of Ramadan is one of the obligatory duties in Islam, which includes refraining from consuming food and drinks and engaging in sexual activity from dawn to sunset. Though pregnant women are exempted from this practice, approximately 80-90% of Muslim pregnant women choose to fast during Ramadan as part of their religious and cultural beliefs. The impact of fasting holy month of Ramadan during pregnancy on pregnancy/birth outcome remains under debate, despite several primary research studies and literature reviews. Up to date, no guidelines or recommendations have been formulated regarding fasting holy month of Ramadan for pregnant Muslim women in US or other settings. The aim of this umbrella review was to assess the current evidence on the impacts of fasting holy month of Ramadan during pregnancy on pregnancy/birth outcomes, which is a prerequisite to develop evidence-based guidelines. We systematically searched PubMed, CINAHL, Cochrane Registry of Systematic Reviews databases, and google scholar to identify systematic reviews that focused on the impact of fasting holy month of Ramadan on pregnancy/birth outcomes including birth weight (continuous), low birth weight, preterm birth, C-Section, stillbirth, small for gestational age, preeclampsia, gestational diabetes, miscarriage, ectopic pregnancy, gestational diabetes, and gestational hypertension. Of 946 records identified, 13 reviews met the inclusion criteria and were included for analysis (4 of high quality, 6 of moderate quality, and 3 of low quality as peer MOOSE 2 checklist). Our findings showed that there is currently no evidence for adverse pregnancy/birth outcomes due to fasting during pregnancy. One review showed statistically significant (p=0.03) but clinically non-significant difference in birth weight of children of mothers who fasted and those who did not. The lack of evidence could be due to several unmeasured confounding factors such as maternal age, number of days of fasting, and pregnancy trimester in which fasting occurred. There is a need for more rigorous primary research studies that control for potential confounders and include a clear definition of exposure to generate the evidence necessary to formulate evidence-based recommendations.