Maternal and perinatal outcome of Ramadan fasting in women with gestational diabetes

Saba Abdullah; Shumaila; Saba Mughal; Mahwish Samuel; Nazli Hossain

doi:10.12669/pjms.39.2.7332

Maternal and perinatal outcome of Ramadan fasting in women with gestational diabetes

Pak J Med Sci. 2023 Mar-Apr;39(2):323-329. doi: 10.12669/pjms.39.2.7332.

Authors

Saba Abdullah¹, Shumaila², Saba Mughal³, Mahwish Samuel⁴, Nazli Hossain⁵

Affiliations

¹ Saba Abdullah, MBBS., Postgraduate Resident, Dow University of Health Sciences, Karachi, Pakistan.
² Shumaila, MBBS., Postgraduate Resident, Dow University of Health Sciences, Karachi, Pakistan.
³ Saba Mughal, M.Phil., Lecturer, School of Public Health, Dow University of Health Sciences, Karachi, Pakistan.
⁴ Mahwish Samuel, MBBS., Postgraduate Resident, Holy Family Hospital, Karachi, Pakistan.
⁵ Nazli Hossain, MBBS, FCPS, MBE., Professor, Dept. of Obstetrics & Gynecology Unit-I, Dow University of Health Sciences, Karachi, Pakistan.

Abstract

Objective: To compare maternal and perinatal outcome of Ramadan fasting during pregnancy in women with/without gestational diabetes.

Methods: This prospective case-control study was conducted at Department of Obstetrics & Gynecology Unit 1 Ruth PKM Civil Hospital & Dow Medical College and Holy Family Hospital, Karachi during 1^st April to 31^st July, 2022. In this study normoglycemic pregnant women and those identified as gestational diabetes (n=52) on oral glucose tolerance test, who fasted during Ramadan were included. Women, on diet control or diet plus metformin were included in the study. Study questionnaire included demographic details, days of fasting, self-reported hypoglycemic episodes. Maternal outcomes included preterm birth, pregnancy induced hypertension. Perinatal outcome included hyperbilirubinemia, hypoglycemia, weight of placenta, and apgar score.

Result: Eighty two women were included in the study, gestational diabetes (n=57) and normoglycemic (n=25). Average days of fasting were 16 ±9.0 days (range 5-30). Women with GDM were older (28.6 vs. 26.0 years, p-value=0.034), had raised levels of HbA1c (5.5 vs. 5.1, p-value=0.004), mean FBS (102.8 vs. 84.6 mg/dl, p-value <0.001), mean RBS (135.3 vs. 106.4 mg/dl, p-value <0.001) and had higher BMI at delivery (31.0 vs. 26.6 kg/m², p-value=0.004). HbA1c (p-value=0.016) and head circumference of baby (p-value=0.038) were found lower in the group who fasted for more than 20 days among normoglycemic pregnant women. No other maternal and neonatal outcomes were found to be significantly affected by Ramadan fasting among pregnant women with/without GDM.

Conclusion: Gestational diabetes do not affect maternal and perinatal outcome among pregnant women.

Keywords: Gestational Diabetes Mellitus; Normoglycemia; Pregnancy.