gms | German Medical Science

4th International Conference of the German Society of Midwifery Science (DGHWi)

Deutsche Gesellschaft für Hebammenwissenschaft e. V.

16.02.2018, Mainz

Ramadan during pregnancy in Germany: a survey study about fasting behavior and involvement of medical personnel

Meeting Abstract

  • corresponding author Fabienne Pradella - Johannes Gutenberg-University Mainz, Chair of Statistics and Econometrics, Mainz , Germany
  • Birgit Leimer - Johannes Gutenberg-University Mainz, Chair of Statistics and Econometrics, Mainz, Germany; Graduate School of Economics, Finance and Management, Frankfurt, Germany
  • Anja Fruth - University Medical Center of the Johannes Gutenberg University Mainz, Department of Obstetrics and Gynecology, Mainz, Germany
  • Annette Queißer - University Medical Center of the Johannes Gutenberg University Mainz, Center for Pediatric and Adolescent Medicine, Mainz, Germany
  • Reyn van Ewijk - Johannes Gutenberg-University Mainz, Chair of Statistics and Econometrics, Mainz, Germany

German Association of Midwifery Science. 4th International Meeting of the German Association of Midwifery Science (DGHWi). Mainz, 16.-16.02.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc18dghwiV03

doi: 10.3205/18dghwi03, urn:nbn:de:0183-18dghwi038

This is the English version of the article.
The German version can be found at: http://www.egms.de/de/meetings/dghwi2018/18dghwi03.shtml

Published: February 13, 2018

© 2018 Pradella et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: Due to the continuously rising number of Muslims in Germany, it is crucial to include Islamic-specific topics in pregnancy care provision. In countries with large Muslim populations, most Muslim women fast during Ramadan when they are pregnant; the behavior of pregnant Muslim women in Europe has rarely been the subject of research. It has been shown however, that Ramadan during pregnancy increases the child’s risks for poor cognitive abilities, disabilities and – in adulthood – symptoms for type II diabetes and coronary heart disease [1], [2], [3], [4], [5].

Aim of this Study: We are the first to systematically collect data on the behavior of pregnant Muslim women during Ramadan in Germany. Among other aspects, we want to understand how and where Muslim women in Mainz inform themselves about Ramadan during pregnancy and what advice they have received from medical personnel.

Methods: Pregnant women and women who recently gave birth are asked questions about their behavior during Ramadan in the obstetric wards of the hospitals in Mainz between October 2016 and January 2017 (pilot study) and from May 2017 to March 2018 (main study). Besides asking about the fasting decision, we are also collecting data about their sleeping habits and other dietary changes during Ramadan (i.e. (un)healthier food, drinking behavior), which could have an effect on if and how Ramadan during pregnancy affects the child. Additionally, we are collecting control variables including educational status and country of birth. Subsequently, we are linking the survey data with medical data provided by the obstetric wards. The interviews are conducted in German, Arabic, Turkish and English.

Results: 116 interviews were conducted during the pilot study. 43% fasted at least one day, while 54% of those fasted 20–30 days. Women who fast are significantly younger than women who do not and are more likely to have a lower educational status. The partner’s opinion has only a limited effect on the woman’s decision to fast. 67% of the women who do not fast believe fasting during pregnancy would negatively affect the child’s health. Negative effects were also expected by 20% of those women who fasted.

A minority of women discusses their Ramadan behavior with their gynecologist or midwife (49% of those who fast and 38% of those who do not fast). Only two women reported being proactively approached about Ramadan by medical personnel. While 73% of medical personnel advised against fasting during pregnancy, over one fourth did not indicate potential negative effects.

Relevance: Around 5% of the German population is Muslim – with a growing tendency. The health effects of prenatal exposure to Ramadan and awareness rising among medical personnel are therefore interesting for a relevant subgroup.

Conclusion: Many pregnant Muslim women in Germany fast during Ramadan. Most Muslims however don’t discuss this topic with medical personnel. Awareness rising among gynecologists and midwives about the potential negative health consequences is therefore recommendable.

Ethical criteria and conflict of interests: The study was submitted to an ethics committee and is funded by the German Research Foundation (DFG: EW 139 / 2-1). There is no conflict of interest.


References

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2.
Almond D, Mazumder B, van Ewijk R. In Utero Ramadan Exposure and Children’s Academic Performance. The Economic Journal. 2015;125(589):1501-33. DOI: 10.1111/ecoj.12168 External link
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Majid M F. The persistent effects of in utero nutrition shocks over the life cycle: Evidence from Ramadan fasting. Journal of Development Economics. 2015;177:48–57.
4.
Van Ewijk R. Long-term health effects on the next generation of Ramadan fasting during pregnancy. Journal of Health Economics. 2011;30(6):1246-60. DOI: 10.1016/j.jhealeco.2011.07.014 External link
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Van Ewijk R J G, Painter R C, Roseboom T J. Associations of prenatal exposure to Ramadan with small stature and thinness in adulthood: results from a large Indonesian population-based study. Am J Epidemiol. 2013;177(8):729-36. DOI: 10.1093/aje/kwt023 External link