title: Ramadan fasting and pregnancy: implications for fetal development in summer season.
abstract: OBJECTIVE
  In the Islamic religion, Ramadan is a month in the year that is passed by fasting. Healthy adult individuals are prohibited to eat, drink, and smoke from sunrise to sunset. In the present study, our aim was to assess the relation of Ramadan fasting with fetal development and maternal-fetal Doppler indices in pregnant women.
  
  
  METHODS
  This is a prospective case-control study carried out in the month of Ramadan in 2013 (9 July-7 August). One hundred and six pregnant women at the second and third trimesters of pregnancy were enrolled into the study. The sample size of the fasting group was 83 and the non-fasting group sample size was also 83. Fetal biometric measurements, such as biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, amniotic fluid index, and Doppler indices of both uterine and umbilical arteries were evaluated by gray scala and color Doppler ultrasound at the beginning and end of Ramadan.
  
  
  RESULTS
  At the end of the Ramadan, increase in biparietal diameter, head circumference, and femur length showed a statistically significant difference from initial measurements (P<0.05). When fasting and non-fasting groups were compared separately, an increase in amniotic fluid index was statistically significant in the non-fasting group (P<0.05).
  
  
  CONCLUSIONS
  We demonstrated some adverse effects of Ramadan fasting on fetal development. In the Islamic religion, pregnant individuals have the privilege of not fasting; therefore, they should consider postponing fasting to the postpartum period, especially in the summer season. If they are willing to do so, an appropriate nutritional program should be recommended.
authors.forename: Mehmet Nafi
authors.initials: MN
authors.lastname: Sakar
authors.forename: Huseyin
authors.initials: H
authors.lastname: Gultekin
authors.forename: Bulent
authors.initials: B
authors.lastname: Demir
authors.forename: Vuslat Lale
authors.initials: VL
authors.lastname: Bakir
authors.forename: Deniz
authors.initials: D
authors.lastname: Balsak
authors.forename: Erkut
authors.initials: E
authors.lastname: Vuruskan
authors.forename: Hicran
authors.initials: H
authors.lastname: Acar
authors.forename: Oguz
authors.initials: O
authors.lastname: Yucel
authors.forename: Murat
authors.initials: M
authors.lastname: Yayla
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005215:Fasting / Q000009:adverse effects* / Q000502:physiology; D005260:Female; D047109:Fetal Development; D006801:Humans; D007514:Islam; D011247:Pregnancy / Q000502:physiology*; D011446:Prospective Studies; D012621:Seasons; D016216:Ultrasonography, Prenatal; D055815:Young Adult