Perceptions, practices, and fasting patterns of pregnant women during Ramadan: a multi-center study in Rawalpindi and Islamabad
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Abstract
Objective: To assess perceptions, practices, fasting patterns, and sleeping habits of pregnant women during Ramadan in Rawalpindi and Islamabad cities of Pakistan.
Methods: A cross-sectional study was conducted during Ramadan 1444H (2023) at three private and two public hospitals. Ethical approval was obtained from Shifa International Hospital and Rawalpindi Medical University. Pregnant women with singleton, spontaneous conceptions attending antenatal clinics were included, while those with multiple pregnancies, assisted conception, or significant medical complications were excluded. Data were collected through a structured, self-administered questionnaire. Socioeconomic groups were stratified by hospital type. Data were analyzed using SPSS-21, employing chi-square, t-tests, Wilcoxon signed-rank test, and logistic regression.
Results: Of 1004 participants, 73.0% reported fasting during Ramadan, with 58.1% fasting for 21–30 days. Fasting was more prevalent among lower-income women (82.2%) compared to higher-income women (66.0%, p<0.0001) and among Pathan (86.9%) compared to Punjabi (75.4%) women (p=0.004). First-trimester women fasted more (86.3%) than third-trimester women (69.8%, p<0.0001). Religious sentiment was the most common reason for fasting (79.6%). Mean weight and BMI were significantly lower in fasting women. Daytime sleep increased (1.8±1.9 to 2.4±2.1 hours), whereas nighttime sleep decreased (7.0±1.8 to 5.7±2.1 hours) during Ramadan (p<0.0001). Logistic regression identified trimester, ethnicity, religious sentiment, and perception that women should “never fast” as significant predictors, correctly classifying 80.6% of cases.
Conclusion: Most pregnant women in Rawalpindi/Islamabad fast during Ramadan, primarily due to religious conviction, with patterns influenced by socioeconomic status, ethnicity, and trimester. These findings highlight the need for culturally sensitive counseling by healthcare providers.
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