Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2014

Open Access 01-12-2014 | Research article

Experiences and outcomes of maternal Ramadan fasting during pregnancy: results from a sub-cohort of the Born in Bradford birth cohort study

Authors: Emily S Petherick, Derek Tuffnell, John Wright

Published in: BMC Pregnancy and Childbirth | Issue 1/2014

Login to get access

Abstract

Background

Observing the fast during the holy month of Ramadan is one of the five pillars of Islam. Although pregnant women and those with pre-existing illness are exempted from fasting many still choose to fast during this time. The fasting behaviours of pregnant Muslim women resident in Western countries remain largely unexplored and relationships between fasting behaviour and offspring health outcomes remain contentious. This study was undertaken to assess the prevalence, characteristics of fasting behaviours and offspring health outcomes in Asian and Asian British Muslim women within a UK birth cohort.

Methods

Prospective cohort study conducted at the Bradford Royal Infirmary UK from October to December 2010 comprising 310 pregnant Muslim women of Asian or Asian British ethnicity that had a live singleton birth at the Bradford Royal Infirmary. The main outcome of the study was the decision to fast or not during Ramadan. Secondary outcomes were preterm births and mean birthweight. Logistic regression analyses were used to investigate the relationship between covariables of interest and women’s decision to fast or not fast. Logistic regression was also used to investigate the relationship between covariables and preterm birth as well as low birth weight.

Results

Mutually adjusted analysis showed that the odds of any fasting were higher for women with an obese BMI at booking compared to women with a normal BMI, (OR 2.78 (95% C.I. 1.29-5.97)), for multiparous compared to nulliparous women(OR 3.69 (95% C.I. 1.38-9.86)), and for Bangladeshi origin women compared to Pakistani origin women (OR 3.77 (95% C.I. 1.04-13.65)). Odds of fasting were lower in women with higher levels of education (OR 0.40 (95% C.I. 0.18-0.91)) and with increasing maternal age (OR 0.87 (95% C.I. 0.80-0.94). No associations were observed between fasting and health outcomes in the offspring.

Conclusions

Pregnant Muslim women residing in the UK who fasted during Ramadan differed by social, demographic and lifestyle characteristics compared to their non-fasting peers. Fasting was not found to be associated with adverse birth outcomes in this sample although these results require confirmation using reported fasting data in a larger sample before the safety of fasting during pregnancy can be established.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bajaj S, Khan A, Fathima FN, Jaleel MA, Sheikh A, Azad K, Fatima J, Mohsin F: South Asian consensus statement on women's health and Ramadan. Indian J Endocrinol Metab. 2012, 16 (4): 508-511. 10.4103/2230-8210.97995.CrossRefPubMedPubMedCentral Bajaj S, Khan A, Fathima FN, Jaleel MA, Sheikh A, Azad K, Fatima J, Mohsin F: South Asian consensus statement on women's health and Ramadan. Indian J Endocrinol Metab. 2012, 16 (4): 508-511. 10.4103/2230-8210.97995.CrossRefPubMedPubMedCentral
2.
go back to reference Almond D, Mazumber B: Health capital and the prenatal environment. Am Econ J Appl Econ. 2011, 3 (4): 56-85. 10.1257/app.3.4.56.CrossRef Almond D, Mazumber B: Health capital and the prenatal environment. Am Econ J Appl Econ. 2011, 3 (4): 56-85. 10.1257/app.3.4.56.CrossRef
3.
go back to reference 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 (10): 1053-1056.CrossRefPubMedPubMedCentral 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 (10): 1053-1056.CrossRefPubMedPubMedCentral
4.
go back to reference Alwasel SH, Abotalib Z, Aljarallah JS, Osmond C, Alkharaz SM, Alhazza IM, Harrath A, Thornburg K, Barker DJ: Sex differences in birth size and intergenerational effects of intrauterine exposure to Ramadan in Saudi Arabia. Am J Hum Biol. 2011, 23 (5): 651-654. 10.1002/ajhb.21193.CrossRefPubMed Alwasel SH, Abotalib Z, Aljarallah JS, Osmond C, Alkharaz SM, Alhazza IM, Harrath A, Thornburg K, Barker DJ: Sex differences in birth size and intergenerational effects of intrauterine exposure to Ramadan in Saudi Arabia. Am J Hum Biol. 2011, 23 (5): 651-654. 10.1002/ajhb.21193.CrossRefPubMed
7.
go back to reference Wright J, Small N, Raynor P, Tuffnell D, Bhopal R, Cameron N, Fairley L, Lawlor DA, Parslow R, Petherick ES, Pickett KE, Waiblinger D, West J: Cohort Profile: The Born in Bradford multi-ethnic family cohort study. Int J Epidemiol. 2013, 42 (4): 978-991. 10.1093/ije/dys112.CrossRefPubMed Wright J, Small N, Raynor P, Tuffnell D, Bhopal R, Cameron N, Fairley L, Lawlor DA, Parslow R, Petherick ES, Pickett KE, Waiblinger D, West J: Cohort Profile: The Born in Bradford multi-ethnic family cohort study. Int J Epidemiol. 2013, 42 (4): 978-991. 10.1093/ije/dys112.CrossRefPubMed
8.
go back to reference Awwad J, Usta IM, Succar J, Musallam KM, Ghazeeri G, Nassar AH: The effect of maternal fasting during Ramadan on preterm delivery: a prospective cohort study. BJOG. 2012, 119 (11): 1379-1386. 10.1111/j.1471-0528.2012.03438.x.CrossRefPubMed Awwad J, Usta IM, Succar J, Musallam KM, Ghazeeri G, Nassar AH: The effect of maternal fasting during Ramadan on preterm delivery: a prospective cohort study. BJOG. 2012, 119 (11): 1379-1386. 10.1111/j.1471-0528.2012.03438.x.CrossRefPubMed
10.
go back to reference Faul F, Erdfelder E, Buchner A, Lang AG: Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Meth. 2009, 41 (4): 1149-1160. 10.3758/BRM.41.4.1149.CrossRef Faul F, Erdfelder E, Buchner A, Lang AG: Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Meth. 2009, 41 (4): 1149-1160. 10.3758/BRM.41.4.1149.CrossRef
11.
go back to reference van Ewijk RJ, Painter RC, Roseboom TJ: Associations of prenatal exposure to Ramadan with small stature and thinness in adulthood: results from a large Indonesian population-based study. Am J Epidemiol. 2013, 177 (8): 729-736. 10.1093/aje/kwt023.CrossRefPubMed van Ewijk RJ, Painter RC, Roseboom TJ: Associations of prenatal exposure to Ramadan with small stature and thinness in adulthood: results from a large Indonesian population-based study. Am J Epidemiol. 2013, 177 (8): 729-736. 10.1093/aje/kwt023.CrossRefPubMed
12.
go back to reference van Ewijk R: Long-term health effects on the next generation of Ramadan fasting during pregnancy. J Health Econ. 2011, 30 (6): 1246-1260. 10.1016/j.jhealeco.2011.07.014.CrossRefPubMed van Ewijk R: Long-term health effects on the next generation of Ramadan fasting during pregnancy. J Health Econ. 2011, 30 (6): 1246-1260. 10.1016/j.jhealeco.2011.07.014.CrossRefPubMed
15.
go back to reference Joosoph J, Abu J, Yu SL: A survey of fasting during pregnancy. Singapore Med J. 2004, 45 (12): 583-586.PubMed Joosoph J, Abu J, Yu SL: A survey of fasting during pregnancy. Singapore Med J. 2004, 45 (12): 583-586.PubMed
16.
go back to reference Kavehmanesh Z, Abolghasemi H: Maternal Ramadan fasting and neonatal health. J Perinatol. 2004, 24 (12): 748-750. 10.1038/sj.jp.7211189.CrossRefPubMed Kavehmanesh Z, Abolghasemi H: Maternal Ramadan fasting and neonatal health. J Perinatol. 2004, 24 (12): 748-750. 10.1038/sj.jp.7211189.CrossRefPubMed
17.
go back to reference Arab M, Nasrollahi S: Interrelation of Ramadan Fasting and Birth Weight. Med J Islamic Acad Scie. 2001, 14 (3): 91-95. Arab M, Nasrollahi S: Interrelation of Ramadan Fasting and Birth Weight. Med J Islamic Acad Scie. 2001, 14 (3): 91-95.
18.
go back to reference Lumey LH, Stein AD, Kahn HS, van der Pal-de Bruin KM, Blauw GJ, Zybert PA, Susser ES: Cohort profile: the Dutch Hunger Winter families study. Int J Epidemiol. 2007, 36 (6): 1196-1204. 10.1093/ije/dym126.CrossRefPubMed Lumey LH, Stein AD, Kahn HS, van der Pal-de Bruin KM, Blauw GJ, Zybert PA, Susser ES: Cohort profile: the Dutch Hunger Winter families study. Int J Epidemiol. 2007, 36 (6): 1196-1204. 10.1093/ije/dym126.CrossRefPubMed
19.
go back to reference Mubeen SM, Mansoor S, Hussain A, Qadir S: Perceptions and practices of fasting in Ramadan during pregnancy in Pakistan. Iran J Nurs Midwifery Res. 2012, 17 (7): 467-471.PubMedPubMedCentral Mubeen SM, Mansoor S, Hussain A, Qadir S: Perceptions and practices of fasting in Ramadan during pregnancy in Pakistan. Iran J Nurs Midwifery Res. 2012, 17 (7): 467-471.PubMedPubMedCentral
20.
go back to reference Yu Z, Han S, Zhu J, Sun X, Ji C, Guo X: Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PloS one. 2013, 8 (4): e61627-10.1371/journal.pone.0061627.CrossRefPubMedPubMedCentral Yu Z, Han S, Zhu J, Sun X, Ji C, Guo X: Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PloS one. 2013, 8 (4): e61627-10.1371/journal.pone.0061627.CrossRefPubMedPubMedCentral
21.
go back to reference Torloni MR, Betran AP, Daher S, Widmer M, Dolan SM, Menon R, Bergel E, Allen T, Merialdi M: Maternal BMI and preterm birth: a systematic review of the literature with meta-analysis. J Matern Fetal Neonatal Med. 2009, 22 (11): 957-970. 10.3109/14767050903042561.CrossRefPubMed Torloni MR, Betran AP, Daher S, Widmer M, Dolan SM, Menon R, Bergel E, Allen T, Merialdi M: Maternal BMI and preterm birth: a systematic review of the literature with meta-analysis. J Matern Fetal Neonatal Med. 2009, 22 (11): 957-970. 10.3109/14767050903042561.CrossRefPubMed
22.
go back to reference Alwasel SH, Abotalib Z, Aljarallah JS, Osmond C, Alkharaz SM, Alhazza IM, Badr G, Barker DJ: Changes in placental size during Ramadan. Placenta. 2010, 31 (7): 607-610. 10.1016/j.placenta.2010.04.010.CrossRefPubMed Alwasel SH, Abotalib Z, Aljarallah JS, Osmond C, Alkharaz SM, Alhazza IM, Badr G, Barker DJ: Changes in placental size during Ramadan. Placenta. 2010, 31 (7): 607-610. 10.1016/j.placenta.2010.04.010.CrossRefPubMed
Metadata
Title
Experiences and outcomes of maternal Ramadan fasting during pregnancy: results from a sub-cohort of the Born in Bradford birth cohort study
Authors
Emily S Petherick
Derek Tuffnell
John Wright
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2014
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-14-335

Other articles of this Issue 1/2014

BMC Pregnancy and Childbirth 1/2014 Go to the issue