Impact of maternal fasting during Ramadan on fetal Doppler parameters, maternal lipid levels and neonatal outcomes

Department of Obstetrics and Gynecology, Fatih University Faculty of Medicine, Ankara, Turkey.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (Impact Factor: 1.21). 08/2011; 25(7):975-7. DOI: 10.3109/14767058.2011.602142
Source: PubMed

ABSTRACT The aim of the present study was to evaluate whether fasting may cause changes in maternal lipid profile, glucose level and ketonuria, and whether it has any adverse effects on fetal Doppler, birthweight, preterm delivery or cesarean section rate.
Fifty-six consecutive, healthy women with singleton uncomplicated pregnancies of ≥ 28 week gestation who had fasted for at least 10 consecutive days during the study period were defined as the study group. Fifty-four healthy non-fasted women matched for age, parity, and gestational age were defined as the control group. Groups were compared according to fetal middle cerebral artery and umbilical artery systolic/diastolic ratio, maternal serum lipid levels and neonatal outcomes (gestational age at delivery, birthweight, delivery type and neonatal intensive care admission).
No statistical difference was found between the groups according to fetal Doppler parameters, amniotic fluid index, gestational age at delivery, cesarean section rate, birthweight or NICU admission. However, lower levels of VLDL, triglyceride and higher incidence of ketonuria were detected in the fasting group (p < 0.05).
Fasting of healthy women during pregnancy seems to have no adverse effects on amniotic fluid index, fetal Doppler and delivery parameters.

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    • "In the present study, however, MCA, UA, and MCA/UA ratio Doppler measurements showed no significant difference between the fasting and non-fasting groups. Similar Doppler findings were reported by Hizli et al. [21]. "
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    ABSTRACT: Objective To investigate the effects of long-lasting maternal fasting on fetal biometry, amniotic fluid volume, fetal Doppler parameters, and neonatal outcomes. Methods The present study, conducted at Solhan State Hospital, Bingol, Turkey, between July and August 2013 recruited 82 healthy and otherwise normal pregnant women with a gestational age of 29 weeks or more who were fasting for at least 20 days. The control group comprised 87 healthy non-fasting women matched for maternal age, parity, gestational age. Fetal parameters were measured at the beginning and the end of the fasting month. Perinatal outcomes were compared between the groups. Results There were no significant differences between the groups in fetal biometry, fetal Doppler parameters, or neonatal outcomes. In the fasting group, however, there was a significantly greater decrease in amniotic fluid index during the fasting period (P < 0.001). The number of women who initially had a normal amniotic fluid measurement and subsequently developed oligohydramnios was also significantly higher in the religious fasting group (P < 0.05). Conclusion Fetal development, Doppler parameters, and neonatal outcomes were not significantly affected in healthy fasting women; however, there was a significant association between fasting and amniotic fluid index. These findings mandate more frequent follow-up visits for this group of women. Synopsis There was a significant association between fasting and decreased amniotic fluid index. Religious fasting shortened the interval for developing oligohydramnios.
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    ABSTRACT: Please cite this paper as: Awwad J, Usta I, Succar J, Musallam K, Ghazeeri G, Nassar A. The effect of maternal fasting during Ramadan on preterm delivery: a prospective cohort study. BJOG 2012;119:1379-1386. Objective  To determine the effect of fasting during the month of Ramadan on the rate of preterm delivery (PTD). Design  A prospective cohort study of women with singleton pregnancies who elected to fast and matched controls. Setting  Four medical centres in Beirut, Lebanon. Population  Women presenting for prenatal care (20-34 weeks of gestation) during the month of Ramadan, September 2008. Methods  Data were collected prospectively. The frequency of PTD was evaluated in relation to the duration of fasting and the stage of gestation at the time of fasting. Main outcome measures  The primary endpoint was the percentage of pregnant women who had PTD, defined as delivery before 37 completed weeks of gestation. Results  A total of 468 women were approached, of whom 402 were included in the study. There were no differences in smoking history and employment. There was no difference in the proportion of women who had PTD at <37 weeks (10.4% versus 10.4%) or PTD at <32 weeks (1.5% versus 0.5%) in the Ramadan-fasted group and the controls, respectively. The PTD rate was also similar in those who fasted before or during the third trimester. The mean birthweight was lower (3094 ± 467 g versus 3202 ± 473 g, P = 0.024) and the rate of ketosis and ketonuria was higher in the Ramadan-fasted women. On multivariate stepwise logistic regression analysis, fasting was not associated with an increased risk of PTD (odds ratio 0.72; 95% confidence interval 0.34-1.54; P = 0.397). The only factor that had a significant effect on the PTD rate was body mass index (odds ratio 0.43; 95% confidence interval 0.20-0.93; P = 0.033). Conclusions  Fasting during the month of Ramadan does not seem to increase the baseline risk of preterm delivery in pregnant women regardless of the gestational age during which this practice is observed.
    BJOG An International Journal of Obstetrics & Gynaecology 07/2012; 119(11):1379-86. DOI:10.1111/j.1471-0528.2012.03438.x · 3.86 Impact Factor
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    ABSTRACT: Many Muslim women worldwide are pregnant during Ramadan and adhere to Ramadan fasting during pregnancy. In the present study, we determined whether maternal adherence to Ramadan fasting during pregnancy has an impact on the birth weight of the newborn, and whether the effects differed according to trimester in which Ramadan fasting took place. A prospective cohort study was conducted in 130 pregnant Muslim women who attended antenatal care in Amsterdam and Zaanstad, The Netherlands. Data on adherence to Ramadan fasting during pregnancy and demographics were self-reported by pregnant women, and the outcome of the newborn was retrieved from medical records after delivery. The results showed that half of all the women adhered to Ramadan fasting. With strict adherence to Ramadan fasting in pregnancy, the birth weight of newborns tended to be lower than that of newborns of non-fasting mothers, although this was not statistically significant ( - 198 g, 95 % CI - 447, 51, P= 0·12). Children of mothers who fasted in the first trimester of pregnancy were lighter at birth than those whose mothers had not fasted ( - 272 g, 95 % CI - 547, 3, P= 0·05). There were no differences in birth weight between children whose mothers had or had not fasted if Ramadan fasting had taken place later in pregnancy. Ramadan fasting during early pregnancy may lead to lower birth weight of newborns. These findings call for further confirmation in larger studies that should also investigate potential implications for perinatal and long-term morbidity and mortality.
    British Journal Of Nutrition 09/2014; 112(9):1-7. DOI:10.1017/S0007114514002219 · 3.34 Impact Factor