Chaudhry Theresa Thompson
Department of Economics, Lahore School of Economics, Intersection Main Blvd DHV Ph VI and Burki Rd., Burki (Lahore) 53200, Pakistan.
Dialogues Health. 2022 Oct 28;1:100062. doi: 10.1016/j.dialog.2022.100062. eCollection 2022 Dec.
Temporary disruptions to eating and sleeping patterns due to exposure to Ramadan during pregnancy have been shown to increase the probability of disability and chronic health problems later in life. This study aims to analyze the intent-to-treat effect of prenatal exposure to Ramadan (the Islamic month of fasting) on individual disabilities for individuals age 18 to 64 across three provinces encompassing 94% of Pakistan's population.
The study uses observational data from 2017 to 2019 by the UN-supported Multiple Indicator Cluster Survey (MICS) on 187,265 adults in Punjab, 71,895 adults in Sindh, and 91,283 in Khyber Pakhtunkhwa, Pakistan. Excluding data on those age > 64 and observations with incomplete data, multivariate regression analysis was conducted on the data of around 277,000 individuals to assess the risk of disability due to pregnancy coinciding with Ramadan.
Considering exposure to Ramadan by calendar month prior to birth, women exposed in particular months have lower rates of disability related to sight (-0.3 percentage point, < 0.1), memory (-0.3 pp., < 0.05), and mobility (-0.6 pp., p < 0.05) but a higher chance of hearing problems (0.2 pp., p < 0.1) as compared to women who were not exposed in utero, while men exposed in particular months have a higher likelihood of a disability in sight (0.5 pp., < 0.05), hearing (0.4 pp., p < 0.05), communication (0.5 pp., < 0.01), memory (0.5 pp., p < 0.05), or mobility (0.9 pp., p < 0.01) as compared to men who were not exposed to Ramadan and women who were similarly exposed. Considering the provinces separately, the results were dominated by Punjab where overlap of pregnancy with Ramadan increased the likelihood of men experiencing a severe disability in hearing, communication, memory, or mobility. Men in Sindh were more likely to experience a memory or mobility disability, and men in Khyber Pakhtunkhwa were less likely to experience a communication or memory disability.
Pregnant women should be counseled regarding the alterations in eating, nutrition, and sleep patterns that may occur during Ramadan, as exposure to Ramadan during pregnancy increases rates of sight, hearing, memory, communication, and mobility disabilities in men.
研究表明，孕期因斋月（伊斯兰教的禁食月）导致饮食和睡眠模式暂时中断，会增加日后出现残疾和慢性健康问题的可能性。本研究旨在分析孕期接触斋月（伊斯兰教的禁食月）对巴基斯坦94%人口所在三个省份18至64岁个体残疾情况的意向性治疗效果。
该研究使用了2017年至2019年由联合国支持的多指标类集调查（MICS）的观察数据，涉及巴基斯坦旁遮普省的187,265名成年人、信德省的71,895名成年人以及开伯尔-普赫图赫瓦省的91,283名成年人。排除64岁以上人群的数据以及数据不完整的观察对象后，对约277,000人的数据进行多变量回归分析，以评估孕期恰逢斋月导致残疾的风险。
考虑出生前按日历月份接触斋月的情况，与未在子宫内接触斋月的女性相比，在特定月份接触斋月的女性出现视力相关残疾的比例较低（-0.3个百分点，<0.1）、记忆力相关残疾比例较低（-0.3个百分点，<0.05）、行动能力相关残疾比例较低（-0.6个百分点，p<0.05），但听力问题的几率较高（0.2个百分点，p<0.1）；而与未接触斋月的男性以及同样接触斋月的女性相比，在特定月份接触斋月的男性出现视力残疾的可能性较高（0.5个百分点，<0.05）、听力残疾可能性较高（0.4个百分点，p<0.05）、沟通残疾可能性较高（0.5个百分点，<0.01）、记忆力残疾可能性较高（0.5个百分点，p<0.05）或行动能力残疾可能性较高（0.9个百分点,p<0.01）。分别考虑各个省份，旁遮普省的结果占主导地位，孕期与斋月重叠增加了男性出现听力、沟通、记忆力或行动能力严重残疾的可能性。信德省男性更有可能出现记忆力或行动能力残疾，而开伯尔-普赫图赫瓦省男性出现沟通或记忆力残疾的可能性较小。
应就斋月期间可能出现的饮食、营养和睡眠模式变化向孕妇提供咨询，因为孕期接触斋月会增加男性出现视力、听力、记忆力、沟通和行动能力残疾的几率。
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