Fetal programming: studying the potential effects of Ramadan fasting on pregnancy outcomes in women

Abstract

Introduction: Many research centers around the world have been investigating the causes of chronic diseases. Often, this investigation was directed to determine the synchronized causes of the diseases until David Barker developed a new hypothesis known as fetal programming of diseases. He drew researchers’ attention to the importance of studying fetal conditions and linking them to health or disease in later life. Barker found that some maternal factors such as suboptimal nutrition are able to disturb fetal organogenesis. As nutrients in maternal blood becomes low, the fetus trads-off nutrients towards the most important organs such as the heart at the expense of the lesser important organs such as kidneys. The majority of pregnant women fast during Ramadan. This may reduce nutrients’ levels in maternal blood, which increases the possibility of nutrients trade-off away from less-important fetal organs. Methods: This study was conducted on 441 healthy Saudi pregnant women. The sample was divided into four groups: the first group included non-fasting women, the second (T1), third (T2) and fourth group (T3) included women who were exposed to Ramadan during the first, second, or third trimester of pregnancy, respectively. On birth day, physical measurements of newborns were recorded. Placenta’s physical measurements and histological examination were recorded too. PCR technique was also used to evaluate the gene expression of glucose transporters, GLUT-1 and GLUT-3. The data were analyzed statistically to compare the total of the fasting group in general with the non-fasting group, then compare the group of fasting according to every third versus non-fasting. Results: Placenta morphopathology are more frequent in fasting groups, especially in T3 group. Placental weight was decreased in T3. Placentas from women who were exposed to Ramadan seemed to have fewer and less-differentiated syncytial knots. Placentas of T3 women had an increase in the expression of GLUT3. Newborn measurements were significantly reduced in fasting group compared to non-fasting group. Conclusion: Based on the results, it has been observed that all most of effects occurred among fasting during the last three months of pregnancy. Hence it is important to conduct future studies to examine the possible effects of a suboptimal uterine environment on fetal disease programming in the future.