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

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.