Department of Economics, Lahore School of Economics, Intersection Main Blvd DHV Ph VI and Burki Rd., Burki, Lahore, 53200, Pakistan.
Matern Child Health J. 2021 Jul;25(7):1136-1146. doi: 10.1007/s10995-021-03154-y. Epub 2021 Apr 28.
This study analyzes the intent-to-treat effect of prenatal exposure to Ramadan (the Islamic month of fasting) on outcomes including stunting and underweight for children under age 5 years in Pakistan born between 2003 and 2018.
The study uses observational data from four rounds of the UN-supported Multiple Indicator Cluster Survey (MICS) data collected on 204,186 children under-5 from Punjab, Pakistan in 2007-2008, 2010-2011, 2013-2014, and 2017-2018. Excluding data on outliers and observations with incomplete data, multivariate logistic regression analysis was conducted on the appended cross-sectional data of 179,943 children under-5 to assess the risk of stunting or underweight according to the month of gestation coinciding with Ramadan.
We observe a significant increase in the risk of stunting and underweight associated with exposure to Ramadan following an inverted-U pattern. The peak impact of Ramadan exposure on a child being underweight occurs in the third month of pregnancy, where the probability of being underweight is 20 percent higher as compared to children whose gestation did not coincide with Ramadan. The peak impact of Ramadan exposure on stunting occurs in the fourth month of pregnancy, where the probability of stunting is 22 percent higher as compared to children whose gestation did not coincide with Ramadan. These results vary little by gender. In contrast, exposure to Ramadan in the ninth month of gestation is associated with a reduction in the risk of stunting for boys and underweight for both boys and girls.
Our analysis indicates that prenatal exposure to Ramadan during the first two trimesters have negative implications for children's growth. The study highlights the critical role of maternal habits during early pregnancy, especially nutritional intake, for the long-term physical development of children.
本研究分析了 2003 年至 2018 年期间在巴基斯坦出生的 5 岁以下儿童在怀孕期间接触斋月（伊斯兰教的斋戒月）的意向治疗效果，包括发育迟缓及体重不足的相关结果。
本研究使用了联合国支持的多指标类集调查（MICS）四轮数据中的观察性数据，该数据收集了 2007-2008 年、2010-2011 年、2013-2014 年和 2017-2018 年期间巴基斯坦旁遮普邦 204186 名 5 岁以下儿童的数据。排除异常值和数据不完整的观察值后，对 179943 名 5 岁以下儿童的附加横截面数据进行多变量逻辑回归分析，以评估根据孕期间与斋月重合的月份评估发育迟缓或体重不足的风险。
我们发现，与不接触斋月的情况相比，孕期间接触斋月与发育迟缓及体重不足的风险呈倒 U 型相关增加。接触斋月导致儿童体重不足的峰值影响出现在怀孕第三个月，此时体重不足的概率比孕期间不接触斋月的儿童高 20%。接触斋月导致发育迟缓的峰值影响出现在怀孕第四个月，此时发育迟缓的概率比孕期间不接触斋月的儿童高 22%。这些结果在性别方面差异不大。相比之下，孕晚期（第九个月）接触斋月与男孩发育迟缓风险降低和男女孩体重不足风险降低有关。
我们的分析表明，孕早期接触斋月对儿童的生长有负面影响。该研究强调了母亲在孕早期的习惯，特别是营养摄入，对儿童长期身体发育的重要性。
