Study / Country |
Study design |
N |
Trimester |
Mean maternal age (y) |
Type of
fasting |
Main finding |
Naderi (2004)
Iran
|
Case-control
|
101
|
Second and third
|
Case = 28.3 (5.5)
Control = 28.8 (5.7)
|
Ramadan fasting
|
No significant difference in fundal height increase in 5 performed
examinations, and mean BW between study groups.
|
Dikensoy (2008, 2009)
Turkey
|
Prospective cohort
|
65
|
Second and third
|
Fasting = 24.0 (5.3)
Control = 26.0 (4.2)
|
Ramadan fasting
|
No difference in increase in BPD, FL, EFBW, and fetal BPP and AFI
between the groups. Fetal BPP and AFI were within normal ranges in both
groups.
|
Alwasel et al (2010)
Saudi Arabia
|
Retrospective cohort
|
7083
|
First, second and third
|
29.5
|
Ramadan fasting
|
No difference in birth weight between babies in utero and not in the
utero during Ramadan regardless of the trimester and gender. No
difference in other outcomes (BW, HC, CC), between babies in utero and
not in utero during Ramadan, regardless gender.
|
Ziaee (2010)
Iran
|
Retrospective cohort
|
189
|
First, second and third
|
25.9
|
Ramadan fasting
|
No significant increase in risk of low BW with fasting in the first
trimester. No significant differences between BW, length, HC and number
of days on fasting.
|
Alwasel (2011)
Saudi Arabia
|
Retrospective cohort
|
967
|
First, second and third
|
Boys = 29.3 (6.1)
Girls = 29.5 (5.9)
|
Ramadan fasting
|
Babies who were boys and were in the second trimester of gestation
during Ramadan were significantly longer at birth than babies that were
not in utero during Ramadan and baby girls. Girls who were in their
second trimester of gestation during Ramadan had significantly shorter
gestation periods.
|
Moradia (2011)
Iran
|
Case-control
|
52
|
Second and third
|
Fasting = 28.3 (5.5)
Non-fasting = 28.3 (5.5)
|
Ramadan fasting
|
No significant difference between fasting and non-fasting groups in
terms of increase in BPD, FL, AC, fetal weight (fetal weight gain,
increase in gestational age related to BPD, FL and AC, and changes in
AFI.
|
Ozturk (2011)
Turkey
|
Prospective cohort
|
72
|
Second
|
Fasting = 30.1
Control = 29.5
|
Ramadan fasting
|
No significant difference in birth weight between study groups.
|
Awwad (2012)
Lebanon
|
Prospective cohort
|
402
|
Second and third
|
Fasting = 29.7 (5.2)
Control = 30.0 (5.4)
|
Ramadan fasting
|
Neonates of fasted women had lower BW than controls. No significantly
different in preterm delivery rates, small for gestational age, and
gestational age at delivery.
|
Petherick (2014)
United Kingdom
|
Prospective cohort
|
300
|
First, second and third
|
Fasted = 27.6 (4.7)
None = 29.0 (5.4)
|
Ramadan fasting
|
No significant association between fasting, preterm birth and low BW
before and after adjustment for other covariables
|
Savitri (2014)
Netherlands
|
Prospective cohort
|
130
|
First, second and third
|
Fasting < half a month = 28.9 (4.9)
Fasting > half a month = 28.9 (4.7)
Non-fasting = 29.3 (4.2)
|
Ramadan fasting
|
Significantly lower BW of new-borns of women who fasted in the first
trimester than non-fasting women, after adjustment for covariates. No
differences in BW found in the second or third trimester. Lowest BW in
new-borns of women who fasted more than half a month, but no significant
interaction suggesting the opposing effects of fasting per trimester of
exposure.
|
Seckin (2014)
Turkey
|
Prospective cohort
|
169
|
Third
|
Fasting = 24.0 (4.2)
Non-fasting = 26.1 (5.9)
|
Ramadan fasting
|
Significantly greater mean BW and change in AFI in fasting women
compared to non-fasting group. The number of patients who initially had
a normal amniotic fluid measurement and subsequently developed
oligohydramnios was significantly higher in the religious fasting group
than in the non-fasting group. No significant differences in changes in
BPD, AC, FL, fetal weight gain, changes in age-BPD, age-FL, age-AC, and
mean gestational age at delivery between groups.
|
Karateke (2015)
Turkey
|
Prospective cohort
|
240
|
First, second and third
|
26.2 (3.7)
|
Ramadan fasting
|
Lower AFI in fasting than without fasting among pregnant women in the
second trimester. No significant differences between the groups in terms
of increase of fetal BPD, increase of fetal femur length, increase of
fetal EFBW, AFI in first and third trimesters, newborn BW, rate of low
BW, and Apgar score.
|
Sakar (2015)
Turkey
|
Case-control
|
166
|
Second and third
|
Fasting = 26.8 (5.2)
Non-fasting = 28.4 (5.0)
|
Ramadan fasting
|
Significant difference in increase in BPD, HC, FL, increase in
gestational age related to HC and FL between groups. Increase in AFI was
significant in the non-fasting group only. No significant differences in
increase in AC, gestational age related to BPD, AC and fetal weight gain
between groups.
|
Abd-Allah Rezk et al (2016)
Egypt
|
Case-control
|
450
|
Third
|
Fasting = 23.2 (4.3)
Non-fasting = 23.0 (4.0)
|
Ramadan fasting
|
No significant differences in reactivity of NST, modified biophysical
scores, gestational age at delivery, neonatal weight, 5-min Apgar scores
and admission to neonatal intensive care unit. Short-term maternal
fasting has no deleterious effect on fetal well-being parameters or
neonatal outcome.
|
Sakar (2016)
Turkey
|
Case-control
|
338
|
Third
|
Fasting = 28.0 (5.8)
Non-fasting = 27.6 (5.5)
|
Ramadan fasting
|
No significant differences in mean BW, height and HC between
groups.
|
Tith (2019)
Canada
|
Retrospective cohort
|
3123508
|
First, second and third
|
NA
|
Ramadan fasting
|
Ramadan fasting in week 15-21 and 22-27 of gestation were associated
with greater risk of very preterm birth.
|
Bernier (2021)
Canada
|
Retrospective cohort
|
78623
|
First and second
|
35.0
|
Ramadan fasting
|
Ramadan fasting has no significant association with the risk of early or
late stillbirth overall.
|
Hossain (2021)
Pakistan
|
Prospective cohort
|
215
|
Third
|
Fasted = 26.54 (4.82)
Not fasted = 26.84 (5.06)
|
Ramadan fasting
|
5-min Apgar scores are significantly higher in the fasted group than the
non-fasted group. However, there is no significant difference in rate of
preterm delivery and anthropometric measurements between both
groups
|