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Ramadan fasting and newborn's birth weight in pregnant Muslim women in The Netherlands

  • Ary I. Savitri (a1), Nasim Yadegari (a2), Julia Bakker (a2), Reyn J. G. van Ewijk (a3), Diederick E. Grobbee (a1), Rebecca C. Painter (a2), Cuno S. P. M. Uiterwaal (a1) and Tessa J. Roseboom (a2) (a4)...


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.


Corresponding author

* Corresponding author: T. J. Roseboom, email


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1 Wu, G, Imhoff-Kunsch, B & Girard, AW (2012) Biological mechanisms for nutritional regulation of maternal health and fetal development. Paediatr Perinat Epidemiol 26, 426.
2 Mparmpakas, D, Goumenou, A, Zachariades, E, et al. (2013) Immune system function, stress, exercise and nutrition profile can affect pregnancy outcome: lessons from a Mediterranean cohort. Exp Ther Med 5, 411418.
3 Tegethoff, M, Greene, N, Olsen, J, et al. (2010) Maternal psychosocial adversity during pregnancy is associated with length of gestation and offspring size at birth: evidence from a population-based cohort study. Psychosom Med 72, 419426.
4 Stein, AD, Zybert, PA, Margot, B, et al. (2004) Intrauterine famine exposure and body proportions at birth: The Dutch Hunger Winter. Int J Epidemiol 33, 831836.
5 Roseboom, TJ, Painter, RC, van Abeelen, AF, et al. (2011) Hungry in the womb: what are the consequences? Lessons from the Dutch famine. Maturitas 70, 141145.
6 Barker, DJP (2007) The origins of the developmental origins theory. J Intern Med 261, 412417.
7 Roseboom, T, de Rooij, S & Painter, R (2006) The Dutch famine and its long-term consequences for adult health. Early Hum Dev 82, 485491.
8 Van Ewijk, R (2011) Long-term health effects on the next generation of Ramadan fasting during pregnancy. J Health Econ 30, 12461260.
9 Ziaee, V, Kihanidoost, Z, Younesian, M, et al. (2010) The effect of Ramadan fasting on outcome of pregnancy. Iran J Pediatr 20, 181186.
10 Kavehmanesh, Z & Abolghasemi, H (2004) Maternal Ramadan fasting and neonatal health. J Perinatol 24, 748750.
11 Arab, M & Nasrollahi, S (2001) Interrelation of Ramadan fasting and birth weight. Med J Islam Acad Sci 14, 9195.
12 Almond, D & Mazumder, B (2011) Health capital and the prenatal environment: the effect of Ramadan observance during pregnancy. Am Econ J Appl Econ 3, 5685.
13 van Ewijk, RJG, Painter, RC & Roseboom, TJ (2013) Associations of prenatal exposure to Ramadan with small stature and thinness in adulthood: results from a large Indonesian population-based study. Am J Epidemiol 177, 729736.
14 Makki, A (2002) Impact of Ramadan fasting on birth weight in 4 hospitals in Sana'a city, Yemen. Saudi Med J 23, 14191420.
15 Alwasel, SH, Abotalib, Z, Aljarallah, JS, et al. (2011) Sex differences in birth size and intergenerational effects of intrauterine exposure to Ramadan in Saudi Arabia. Am J Hum Biol 23, 651654.
16 Al-Hourani, H & Atoum, M (2007) Body composition, nutrient intake and physical activity patterns in young women during Ramadan. Singapore Med J 48, 906910.
17 Dikensoy, E, Balat, O, Cebesoy, B, et al. (2008) Effect of fasting during Ramadan on fetal development and maternal health. J Obstet Gynaecol Res 34, 494498.
18 Ozturk, E, Balat, O, Ugur, MG, et al. (2011) Effect of Ramadan fasting on maternal oxidative stress during the second trimester: a preliminary study. J Obstet Gynaecol Res 37, 729733.
19 Cross, JH, Eminson, J & Wharton, BA (1990) Ramadan and birth weight at full term in Asian Moslem pregnant women in Birmingham. Arch Dis Child 65, 10531056.
20 Alwasel, SH, Abotalib, Z, Aljarallah, JS, et al. (2011) Secular increase in placental weight in Saudi Arabia. Placenta 32, 391394.
21 Almond, D & Mazumder, B (2008) Health capital and the prenatal environment: the effect of maternal fasting during pregnancy. Cambridge.
22 Awwad, J, Usta, I, Succar, J, et al. (2012) The effect of maternal fasting during Ramadan on preterm delivery: a prospective cohort study. BJOG 119, 13791386.
23 Shahgheibi, S, Ghadery, E & Pauladi, A (2005) Effects of fasting during the third trimester of pregnancy on neonatal growth indices. Ann Alquds Med 1, 5862.
24 Mirghani, HM, Weerasinghe, DSL, Ezimokhai, M, et al. (2003) The effect of maternal fasting on the fetal biophysical profile. Int J Gynecol Obstet 81, 1721.
25 Dikensoy, E, Balat, O, Cebesoy, B, et al. (2009) The effect of Ramadan fasting on maternal serum lipids, cortisol levels and fetal development. Arch Gynecol Obstet 279, 119123.
26 Moradi, M (2011) The effect of Ramadan fasting on fetal growth and Doppler indices of pregnancy. J Res Med Sci 16, 165169.
27 Prentice, AM, Prentice, A, Lamb, WH, et al. (1983) Metabolic consequences of fasting during Ramadan in pregnant and lactating women. Hum Nutr Clin Nutr 37, 283294.
28 Malhotra, A, Scott, PH, Scott, J, et al. (1989) Metabolic changes in Asian Muslim pregnant mothers observing the Ramadan fast in Britain. Br J Nutr 61, 663672.
29 Hizli, D, Yilmaz, SS, Onaran, Y, et al. (2012) Impact of maternal fasting during Ramadan on fetal Doppler parameters, maternal lipid levels and neonatal outcomes. J Matern Fetal Neonatal Med 25, 975977.
30 Rabinerson, D, Dicker, D, Kaplan, B, et al. (2000) Hyperemesis gravidarum during Ramadan. J Psychosom Obstet Gynecol 21, 189191.
31 Alwasel, SH, Abotalib, Z, Aljarallah, JS, et al. (2010) Changes in placental size during Ramadan. Placenta 31, 607610.
32 Harding, J, Jaquiery, A, Hernandez, C, et al. (2011) Animal studies of the effects of early nutrition on long-term health. Nestle Nutr Workshop Ser Paediatr Program 68, 111.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
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