Is it safe to fast during pregnancy?

Fasting during the holy month of Ramadan is a significant religious practice observed by millions of Muslims worldwide. It involves abstaining from food, drink, and other physical needs from dawn until sunset. 

For pregnant women, however, fasting can pose unique challenges and health considerations. Understanding the interrelation between Ramadan fasting and pregnancy is essential for expectant mothers and their families.

Expectant mothers face a dilemma during Ramadan as they balance their religious obligations with their health and the well-being of their unborn child. While Islam exempts pregnant women from fasting if it poses a risk to their health or the health of the baby, many women still wish to observe the fast as much as possible due to its spiritual significance.

Doctors, however, suggest that several factors need to be taken into account, including the mother's overall health, the stage of pregnancy, any pre-existing medical conditions, and the nutritional needs of both the mother and the developing fetus.

"During pregnancy, the body's immune system is naturally compromised, and approximately 10%-20% of women develop gestational diabetes. Managing gestational diabetes involves consuming small, frequent meals rather than large ones. Following such advice becomes challenging during fasting," Rezaul Karim Kazal, professor of Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University, told The Business Standard.

He stated that uncontrolled gestational diabetes or pregnancy-related infections can result in complications such as miscarriage, premature delivery, maternal hypertension, and low birth weight in infants.

"Prolonged fasting can lead to a decrease in glucose levels in the mother's body, prompting excess fat metabolism and the production of ketone bodies, which pose risks to the unborn child," he added.

The professor mentioned that doctors typically advise pregnant mothers to consume an additional 300-500 calories compared to their normal intake.

"Additionally, opting for frequent, smaller meals - six to eight times a day instead of the usual three -promotes the mother's well-being and ensures proper growth of the baby," said Dr Rezaul Karim.

Sadiya Israt Smreety, visiting nutrition specialist at Dr Sirajul Islam Medical College and Hospital, noted that the impact of fasting on pregnancy is limited.

"However, pregnant women interested in fasting should consult their doctor beforehand. If they have no underlying medical conditions, they can keep fast," the nutrition specialist told The Business Standard. 

A study published in The Journal of Nutrition in 2000 found that pregnant women who fasted during Ramadan had lower intakes of energy, protein, and several micronutrients compared to non-fasting pregnant women.

Another study published in the Saudi Medical Journal in 2003 reported that fasting during Ramadan did not significantly affect maternal weight gain during pregnancy.

According to a study published in the European Journal of Obstetrics, Gynecology, and Reproductive Biology in 2006, fasting during Ramadan might lead to alterations in maternal metabolic parameters, such as blood glucose levels and lipid profiles.

Experts, however, suggest that individual circumstances should be considered, and pregnant women who choose to fast during Ramadan should receive appropriate medical supervision and nutritional counselling.