Knowledge, Attitudes and Practices of Ramadan Fasting in Pregnant Thai-Muslim Women

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Saowanee Saro Somchai Tanawattanacharoen


Objectives: To assess the basic religious knowledge regarding the Islamic law, attitudes and practices of Ramadan fasting during pregnancy in Thai-Muslim women.
Materials and Methods: Multicenter, cross-sectional descriptive study was conducted between July 2016 and January 2017 on 619 pregnant Muslim women at antenatal care clinic from six hospitals in the three southernmost provinces of Thailand. Non-probability convenient sampling technique and a questionnaire were used to collect data from pregnant women who had experienced pregnancy during Ramadan at least once in their lives.
Results: Most participants (85.5%) reported to have knowledge regarding the Islamic law clear exemption from fasting for pregnant women, and the missed fasts must be completed later. Majority of pregnant women believed the fasting during pregnancy did no harm to maternal health. Overall, 87.1% observed fasting during pregnancy. Mean fasting days was 24.56 ± 5.66 days and 63.0% observed fasting between 21-30 days. Logistic regression analysis demonstrated that their age ≥ 35 years and Islamic education increased the fasting during pregnancy (Adjusted OR 2.478, 95%CI 1.174–5.230, p = 0.017 and 2.244, 95%CI 1.236–3.988, p = 0.006, respectively). The main adversities from Ramadan fasting during pregnancy were weakness and fatigue.
Conclusion: Most pregnant women knew Islamic law clear exemption from fasting during pregnancy, however many of pregnant women preferred fasting during Ramadan and they believed the fasting during pregnancy did no harm to maternal health. Healthcare providers are required to understand the religious beliefs of Muslim pregnant women, and design the standard guideline about managing lifestyle changes of Ramadan fasting during pregnancy.

Keywords: Knowledge, attitudes, practices, Ramadan, Fasting, pregnant Thai-Muslim women.


Article Details

Original Article


1. Lou A, Hammoud M. Muslim patients’ expectations and attitudes about Ramadan fasting during pregnancy. Int J Gynaecol Obstet 2016;132:321-4.
2. Cross-Sudworth F. Effects of Ramadan fasting on pregnancy. Br J Midwifery 2007;15:79-81.
3. Joosoph J, Abu J, Yu SL. A survey of fasting during pregnancy. Singapore Med J 2004;45:583-6.
4. Van Ewijk R. Long-term health effects on the next generation of Ramadan fasting during pregnancy. J Health Econ 2011;30:1246-60.
5. Robinson T, Raisler J. “Each one is a doctor for herself”: Ramadan fasting among pregnant Muslim women in the United States. Ethn Dis 2005;15 Suppl:99-103.
6. Najimudeen M. Pregnancy and Ramadhan Fasting. Br J Med Med Res 2016; 16:1-14.
7. Mubeen SM, Mansoor S, Hussain A, Qadir S. Perceptions and practices of fasting in Ramadan during pregnancy in Pakistan. Iran J Nurs Midwifery Res 2012; 17:467-71.
8. Saeun M. Self-care experiences in Thai-Muslim women practicing Ramadan fasting during pregnancy (unpublished dissertation). Bangkok: Chulalongkorn University; 2005. [cited 2016 August 15].
9. Savitri AI, Yadegari N, Bakker J, van Ewijk RJ, Grobbee DE, Painter RC, et al. Ramadan fasting and newborn’s birth weight in pregnant Muslim women in The Netherlands. Br J Nutr 2014;112:1503-9.
10. Bajaj S, Khan A, Fathima FN, Jaleel MA, Sheikh A, Azad K, et al. South Asian consensus statement on women’s health and Ramadan. Indian J Endocrinol Metab 2012;16:508-11.
11. Cross JH, Eminson J, Wharton BA. Ramadan and birth weight at full term in Asian Moslem pregnant women in Birmingham. Arch Dis Child 1990;65:1053-6.
12. Petherick ES, Tuffnell D, Wright J. Experiences and outcomes of maternal Ramadan fasting during pregnancy: results from a sub-cohort of the Born in Bradford birth cohort study. BMC Pregnancy Childbirth 2014;14:335.
13. Dikensoy E, Balat O, Cebesoy B, Ozkur A, Cicek H, Can G. Effect of fasting during Ramadan on fetal development and maternal health. J Obstet Gynaecol Res 2008;34:494-8.
14. Mirsane SA, Shafagh Sh. A narrative review on fasting of pregnant women in the holy month of Ramadan. J Fasting Health 2016;4:53-6.
15. Abd-Allah Rezk M, Sayyed T, Abo-Elnasr M, Shawky M, Badr H. Impact of maternal fasting on fetal well-being parameters and fetal-neonatal outcome: a case-control study. J Matern Fetal Neonatal Med 2016;29:2834–8.
16. Awwad J, Usta IM, Succar J, Musallam KM, Ghazeeri G, Nassar AH. The effect of maternal fasting during Ramadan on preterm delivery: a prospective cohort study. BJOG 2012;119:1379–86.
17. Rabinerson D, Dicker D, Kaplan B, Ben-Rafael Z, Dekel A. Hyperemesis gravidarum during Ramadan. J Psychosom Obstet Gynaecol 2000;21:189-91.
18. Almond D, Mazumder B. Health capital and the prenatal environment: the effect of Ramadan observance during pregnancy. Am Econ J 2011;3:56–85.
19. Ziaee V, Kihanidoost Z, Younesian M, Akhavirad MB, Bateni F, Kazemianfar Z, et al. The effect of ramadan fasting on outcome of pregnancy. Iran J Pediatr 2010; 20:181–6.
20. Mirghani HM, Weerasinghe DS, Ezimokhai M, Smith JR. The effect of maternal fasting on the fetal biophysical profile. Int J Gynaecol Obstet 2003;81:17–21.
21. Mirghani HM, Hamud OA. The effect of maternal diet restriction on pregnancy outcome. Am J Perinatol 2006;23:21-4.
22. Alwasel SH, Abotalib Z, Aljarallah JS, Osmond C, Alkharaz SM, Alhazza IM, et al. Changes in placental size during Ramadan. Placenta 2010;31:607-10.
23. Firouzbakht M, Kiapour A, Jamali B, Kazeminavaei F,Taghlilin F, Gorji AMH. Fasting in pregnancy: a survey of beliefs and manners of Muslim women about Ramadan fasting. Ann Trop Med Pub Health 2013;6:536–40.
24. Van Bilsen LA, Savitri AI, Amelia D, Baharuddin M, Grobbee DE, Uiterwaal CS. Predictors of Ramadan fasting during pregnancy. J Epidemiol Glob Health 2016; 6:267-75.
25. Arab M, Nasrollahi S. Interrelation of Ramadan fasting and birth weight. Med J Islamic World Acad Sci 2001;14:91–5.
26. Bakhotmah BA. The puzzle of self-reported weight gain in a month of fasting (Ramadan) among a cohort of Saudi families in Jeddah, Western Saudi Arabia. Nutr J 2011;10:84.