Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

POSTER DISCUSSION: Ramadan and gestational diabetes: impact of number of Ramadan fasting hours on pregnancy outcomes (#232)

Ted Wu 1 , Glynis P Ross 1 2 , Turki AlMogbel 1 , Lynda Molyneaux 1 2 , Maria Constantino 1 2 , Margaret McGill 1 2 , Anna-Jane Harding 1 , Christine Pech 1 , Abdullah Alrasheed 1 , Jencia Wong 1 2
  1. Diabetes Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  2. Discipline of Medicine, University of Sydney, Sydney, NSW, Australia

Background

Fasting during the month of Ramadan is one of the five pillars of Islam. Despite allowed exemptions ~50% of Muslim women with GDM still opt to fast. This intermittent fasting/feasting pattern and associated disrupted circadian rhythms, may adversely impact fetal and maternal outcomes in the context of GDM. Furthermore, the hours of Ramadan fasting are determined seasonally and we examine the impact of this on pregnancy outcomes.

 

Aim

To examine the relationship between pregnancy outcomes and the hours of Ramadan fasting in Muslim women with GDM using data from a multiethnic GDM database, collected over a 22 year period.

 

Method

Outcomes for 293 Muslim women with singleton pregnancies who attended RPAH Sydney 1989-2010 were available for study. We examined outcomes in relation to the number of hours of Ramadan fasting as determined annually by the Islamic calendar specific to Sydney. Actual fasting hours could not be definitively determined for individual women. Statistical significance was defined as p-value < 0.05.

 

Results

Subjects were divided into never exposed (n=48), Ramadan fasting hours of >12-13 hours (n=31), >13-14 (n=85), >14-15(n=43), >15-16hrs (n=86). There were no differences in maternal age, ethnicity, pre-pregnancy BMI, gestation at diagnosis, maternal weight-gain, preterm delivery or neonatal hypoglycaemia. No significant differences in macrosomia, large for gestational age (LGA) infants were seen, however a trend to increasing birth weight across the groups was seen (ptrend 0.02). Conversely, the highest prevalence of SGA was seen in the non-Ramadan exposed (ptrend 0.03). The positive relationships seen between birthweight and hours of fasting did not persist after adjustment for confounders.

 

Discussion

The correlation seen between birthweight and hours of fasting can largely be explained by known confounders, however the impact of seasons may also have a role.