Impact of Ramadan fasting during pregnancy on maternal and fetal outcomes

Despite numerous primary studies and systematic and narrative reviews, no consensus exists on the effects of Ramadan fasting during pregnancy on maternal and birth outcomes. Currently, there are no evidence-based guidelines for Muslim women regarding fasting while pregnant, leaving clinicians without definitive recommendations.

A new study examined the current evidence on how Ramadan fasting during pregnancy affects pregnancy and birth outcomes.

This umbrella review analyzed systematic and narrative reviews retrieved from PubMed, CINAHL, and the Cochrane Registry of Systematic Reviews between November 2023 and February 2024. All articles assessing the effects of Ramadan fasting on pregnancy and birth outcomes were included. The primary outcomes were birth weight, gestational age, fetal growth indices, Apgar score, risk of cesarean delivery, and the incidence of gestational diabetes and preeclampsia.

Overall, 13 articles met the inclusion criteria – three systematic reviews with meta-analyses, six systematic reviews without meta-analyses, and four narrative reviews. The evidence found no association between Ramadan fasting during pregnancy and reduced gestational age or increased risk of preterm birth. Limited evidence suggested that fasting may slightly affect birth weight, with odds ratios for low birth weight ranging from 1.05-1.37. Moreover, there was no significant link between fasting and cesarean delivery, gestational diabetes, or preeclampsia. However, data on stillbirth, miscarriage, congenital anomalies, or neonatal deaths were lacking.

Current evidence does not strongly support the adverse effects of Ramadan fasting on pregnancy outcomes, but methodological limitations exist in the existing studies. Further high-quality research considering maternal nutritional status, fasting duration, timing, dietary intake, and pre-existing conditions is needed to develop evidence-based recommendations.

Source: Al‐Taiar A, Rahman ME, Salama M, Ziyab AH, Karmaus W. International J Gynec & Obst. 2025.