Effects of Ramadan Fasting on Fetal Health: A Systematic Review.
Background Ramadan fasting (RF) is mandatory for all healthy Muslims in
the ninth month of Islamic calendar. Pregnant women are exempt from
fasting but many willfully practise it. There are concerns that fasting
during pregnancy is harmful to the fetus but there are no firm
recommendations regarding its safety. Objectives To provide a systematic
review on the effects of RF on fetal health. Search Strategy We
conducted literature search for peer-reviewed articles through Ovid
MEDLINE, PubMed, SCOPUS, EMBASE and Cochrane Central Register of
Controlled Trials (CENTRAL) until 31 December 2021. Selection Criteria
All case-control and observational cohort studies that reported on fetal
outcomes of pregnant women who underwent RF for at least 1 day at any
point of time during pregnancy are included. Data Collection and
Analysis Two researchers independently reviewed the eligibility of all
studies. A third researcher resolved any conflict between researchers.
Findings are extracted from eligible papers and presented as narratives.
Main Results 18 articles are included based on eligibility criteria,
with a total sample size of 3,213,070. There are studies demonstrating
negative associations between RF and neonatal weight, amniotic fluid
index, preterm birth and growth parameters mainly during second and
third trimesters, but those evidences are not strongly supported.
Conclusion There is limited data to elucidate the relationship between
RF and fetal health, hence the need for more studies to provide better
understanding. Funding None. Keywords Ramadan fasting, pregnant women,