Skip to main content
SpringerLink
Log in

The effect of Ramadan fasting on maternal serum lipids, cortisol levels and fetal development

  • Original Article
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To determine the effects of fasting during the month of Ramadan on fetal development and maternal serum cortisol and lipid profile.

Methods

This study was performed in Obstetrics and Gynecology Department of Gaziantep University Hospital, between 23 September 2006 and 23 October 2006 (during the month of Ramadan). Thirty-six consecutive healthy women with uncomplicated pregnancies of 20 weeks or more, who were fasting during Ramadan, were included in the study group (group 1). The control group (group 2) consisted of 29 healthy pregnant women, who were not fasting during the study period. For evaluating Ramadan’s effect on fetus, Doppler ultrasonography was performed on all subjects in the beginning and then once a week until the end of Ramadan for the following measurements: increase of fetal biparietal diameter (BPD), increase of fetal femur length (FL), increase of estimated fetal body weight (EFBW), fetal biophysical profile (BPP), amniotic fluid index (AFI), and umbilical artery systole/diastole (S/D) ratio.

Maternal serum cortisol, triglyceride, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), very low density lipoprotein (VLDL), and LDL/HDL ratio were also evaluated before and after Ramadan.

Results

No significant difference was found between the two groups for the fetal age, maternal weight gain (kilogram), estimated fetal weight gain (EFWG), fetal BPP, AFI, and umbilical artery S/D ratio. In the fasting group, the maternal serum cortisol levels on day 20 were significantly higher than the initial levels obtained 1 week prior to Ramadan (p < 0.05). Although no significant increases were observed in total cholesterol and triglyceride levels in the fasting group, these increases were significantly higher than those in the control group (p < 0.05). LDL and VLDL levels showed a non-significant decrease at the end of the Ramadan. HDL levels showed a slight increase, but LDL/HDL ratios were significantly decreased in fasting group (p < 0.05).

Conclusion

The results of this study showed that maternal serum cortisol level was elevated while LDL/HDL ratio were decreased in healthy women with uncomplicated pregnancies of 20 weeks or more, who were fasting during Ramadan. No untoward effect of Ramadan was observed on intrauterine fetal development.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Reilly T, Waterhouse J (2007) Altered sleep-wake cycles and food intake: the Ramadan model. Physiol Behav 90:219–228

    Article  PubMed  CAS  Google Scholar 

  2. Robinson T, Raisler J (2005) Each one is a doctor for herself: Ramadan fasting among pregnant Muslim women in the United States. Ethn Dis 15(1 Suppl 1):S1–99–103.

    Google Scholar 

  3. Joosoph J, Abu J, Yu SL (2004) A survey of fasting during pregnancy. Singapore Med J 45:583–586

    PubMed  CAS  Google Scholar 

  4. Kaplan M, Eidelman AI, Aboulafia Y (1983) Fasting and the precipitation of labor: the Yom Kippur effect. JAMA 250:1317–1318

    Article  PubMed  CAS  Google Scholar 

  5. Cross JH, Emerson J, Wharton BA (1990) Ramadan and birth weight at full term in Asian Moslem pregnant women in Birmingham. Arch DisChild 65:1053–1056

    Article  CAS  Google Scholar 

  6. Hefni M, Fikry SAH, Abdalazim M, Abdelkhalik MA (1993) Fasting in Ramadan and preterm labour. Saudi Med J 14:130–132

    Google Scholar 

  7. Naderi T, Kamyabi Z (2004) Determination of fundal height increase in fasting and non-fasting pregnant women during Ramadan. Saudi Med J 25:809–810

    Google Scholar 

  8. Kamyabi Z, Naderi T (2004) The effect of Ramadan fasting on amniotic fluid volume.Saudi Med J 25:45–6.

    Google Scholar 

  9. Rabinerson D, Dicker D, Kaplan B, Ben-Rafael Z, Deke A (2000) l Hyperemesis gravidarum during Ramadan. J Psychosom Obstet Gynaecol 21:189–191

    Article  PubMed  CAS  Google Scholar 

  10. Fowler H, Griffin E, Lawton F, Buxton J, Luesley D (1990) Antenatal attendance and fasting of pregnant Muslims during Ramadan. Br J Obstet Gynaecol 97:861–862

    PubMed  CAS  Google Scholar 

  11. Salleh H (1989) Ramadan fasting among pregnant women in Muar district, Malaysia and its association to health outcomes. Malays J Reprod Health 7:69–83

    PubMed  CAS  Google Scholar 

  12. Malhotra A, Scott PH, Scott J, Gee H, Wharton BA (1989) Metabolic changes in Asian Muslim pregnant mothers observing the Ramadan fast in Britain. Br J Nutr 61:663–672

    Article  PubMed  CAS  Google Scholar 

  13. Prentice AM, Prentice A, Lamb WH, Lunn PG, Austin S (1983) Metabolic consequences of fasting during Ramadan in pregnant and lactating women. Hum Nutr Clin Nutr 37:283–294

    PubMed  CAS  Google Scholar 

  14. Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK (1985) Estimation of fetal weight with the use of head, body, and femur measurements—a prospective study. Am J Obstet Gynecol 151:333–337

    PubMed  CAS  Google Scholar 

  15. Manning FA, Morrison I, Lange IR, Harman CR, Chamberlain PF (1985) Fetal assessment based on fetal biophysical profile scoring: experience in 12, 620 referred high-risk pregnancies I. Perinatal mortality by frequency and etiology. Am J Obstet Gynecol 151:343–350

    PubMed  CAS  Google Scholar 

  16. Alfirevic Z, Neilson JP (1995) Doppler ultrasonography in high risk pregnancies: systematic review with meta-analysis. Am J Obstet Gynaecol 172:1379

    Article  CAS  Google Scholar 

  17. Nelson W, Cadotte L, Halberg F (1973) Circadian timing of single daily meal affects survival of mice. Proc Soc Exp Biol Med 144:766–769

    PubMed  CAS  Google Scholar 

  18. Salem BL, B’chir S, B’chir F, Bouguerra R et al (2002) Circadian rhytm of cortisol and its responsiveness to ACTH during Ramadan. Ann Endocrinol 63:497–501

    Google Scholar 

  19. Ziaee V, Razaei M, Ahmadinejad Z, Shaikh H, Yousefi R, Yarmohammadi L, Bozorgi F, Behjati MJ (2006) The changes of metabolic profile and weight during Ramadan fasting. Singapore Med J 47:409–414

    PubMed  CAS  Google Scholar 

  20. Tsai AC, Sandretto A, Chung YC (2003) Dieting is more effective in reducing weight but exercise is more effective in reducing fat during the early phase of a weight-reducing program in healthy humans. J Nutr Biochem 14:541–549

    Article  PubMed  CAS  Google Scholar 

  21. Afrasiabi A, Hassanzadeh S, Sattarivand R, Mahboob S (2003) Effects of Ramadan fasting on serum lipid profiles on 2 hyperlipidemic groups with or without diet pattern. Saudi Med J 24:23–26

    PubMed  Google Scholar 

  22. Kiziltan G, Karabudak E, Tuncay G, Avsar F et al (2005) Dietary intake and nutritional status of Turkish pregnant women during Ramadan. Saudi Med J 26(11):1782–1787

    PubMed  Google Scholar 

  23. Maislos M, Khamaysi N, Assali A, Abou-Rabiah Y, Zuili I, Shany S (1993) Marked increase in plasma high-density-lipoprotein cholesterol after prolonged fasting during Ramadan. Am J Clin Nutr 57:640–642

    PubMed  CAS  Google Scholar 

  24. El-Migdadi F, El-Akawi Z, Abudheese R, Bashir N (2002) Plasma levels of adrenocorticotropic hormone and cortisol in people living in an environment below sea level (Jordan Valley) during fasting in the month of Ramadan. Horm Res 58:279–282

    Article  PubMed  CAS  Google Scholar 

  25. el Ati J, Beji C, Danguir J (1995) Increased fat oxidation during Ramadan fasting in healthy women: an adaptative mechanism for body-weight maintenance. Am J Clin Nutr 62:302–307

    PubMed  CAS  Google Scholar 

  26. Patsch JR, Jb Karlin, Scott LW, Smith LC, Gotto AM Jr (1983) Inverse relationship between blood levels of high density lipoprotein subfraction 2 and magnitude of postprandial lipemia. Proc Nac Acad Sci 80:1449–53

    Article  CAS  Google Scholar 

  27. Ben Salem L, B’chir S, Bchir F, Bouguerra R, Ben Slama C (2002) [Circadian rhythm of cortisol and its responsiveness to ACTH during Ramadan]. Ann Endocrinol (Paris) 63:497–501

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Obstetrics and Gynecology Department, Gaziantep University, 27310, Gaziantep, Turkey

    Ebru Dikensoy, Ozcan Balat, Bahar Cebesoy & Gunay Can

  2. Radiology Department, Gaziantep University, Gaziantep, Turkey

    Ayhan Ozkur

  3. Biochemistry Department, Gaziantep University, Gaziantep, Turkey

    Hulya Cicek

Authors
  1. Ebru Dikensoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ozcan Balat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bahar Cebesoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayhan Ozkur
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hulya Cicek
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gunay Can
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ebru Dikensoy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dikensoy, E., Balat, O., Cebesoy, B. et al. The effect of Ramadan fasting on maternal serum lipids, cortisol levels and fetal development. Arch Gynecol Obstet 279, 119–123 (2009). https://doi.org/10.1007/s00404-008-0680-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-008-0680-x

Keywords

Search

Navigation