Butler, overall fetal loss or early infant

Butler, et al, (1972) found in a British population, cigarette smoking during pregnancy increased late fetal and neonatal mortality rate by 28% and reduced birth weight by 170 gram. In a growing literature savior, malnutrition during utero exposure in developing countries is highly associated with Syndrome of developmental impairment in later life especially in early three years of life and increased morbidity and mortality (Martorell, R, 1999). In another study Marilyn K, et al, (1988) examine a case control study of 1,583 pregnant women of North California, 1981-1982 and found a significant risk of miscarriage in those pregnant women they have VDTs for more than 20 hours per week during the first trimester of pregnancy and in conclusion they said underscore the need for large cohort studies of working women.Christian, P, et al (2003) examined the effect of daily maternal micronutrient supplementation on fetal loss and infant mortality and conclude that maternal micronutrient supplement failed to reduced overall fetal loss or early infant mortality among preterm infants while folic acid alone and with iron reduced mortality in the first three month of life and multiple micronutrient may increase mortality risk among term infants. Several other studies shows that intimate partner violence three out of four 75.6% less educated, poorer, and Muslim women were at greater risk, unwanted pregnancy in Bangladesh women Silver, Gupta, Decker and Kapur (2007) , last planned pregnancies n=3174 in  a retrospective population-based study on women aged 25-44 years in Denmark, Germany, Itlay, and Spain. After adding various factors reproductive history, country women age greater then and equal to 35 and partner age 40 paternal age, paternal age higher rate of pregnancy loss rate. Elise and Thonneau (2002). Imbalance chromosome arrangement and uterine malformation during cesarean section in prior birth mainly two main focused point in vast epidemiology literature , nevertheless addiction of caffeine, tobacco use, alcohol, drugs and women previous pregnancy history, age, Menstrual disorders, sexual activity in early pregnancy, maternal injuries, ovulation induction drugs, contraceptive are the onset other cause of pregnancy termination. A study on Bangladesh district Rajshahi by using multivariate technique on a demographic, health and socioeconomic variable found a strong relationship in between immunization (78% lower), ever breastfeeding, prenatal care of the mother, mother’s age at birth and birth interval (57.7% lower after 36 month gap)  on mortality of neonatal and post-neonatal. They found a significant relationship between father occupations at post-neonatal periods and wrote in a conclusion female education and public health facilities can reduce the risk of child mortality Mondal, et al, 2009, Puffer and Serrano, 1973.With the support of WHO and UNICE Integrated Management of Childhood Illness (IMCI) established in 1990 to prevent children from the major cause of child mortality like diarrhea, pneumonia, malaria, and malnutrition. After the successful implementation of this program child mortality in Bangladesh, gradually start declining with the improvement of health workers skills, health-system support and family and community practices in other words another Jones, et al, 2003.Ghuman, S.J. (2003) consider 15 pairs of Muslims and non-Muslims in India, Malaysia, Philippines, and Thailand to evaluate infant and child mortality related with male-headed household in Muslims society. They found weak association in between child mortality and women autonomy. In another study, a collaborative research project coordinated by Pan American Health Organization selected 15 areas, 1 from US, and 1 from Canada, and other from Latin America, they studied 35,095 deaths of children based on nutritional deficiency on low birth weight children. They found that low birth weight as most savior health outcome variable contributing to early childhood mortality. More than ½ of the children died significantly associated with immaturity and nutritional deficiency. Mortality in a peaked in infancy if nutritional deficiency relate with 3rd or 4th month. Puffer and Serrano, 1973Lumey, L.H, 1992 found lower birthweight in infants in utero exposure in first and second trimester to the Dutch famine of 1944-1945 due to slower fetal growth rate and shorter gestation length, while its not reported in third trimester. In addition, reported on increased perinatal mortality in offspring of such mothers. Intrauterine growth restriction (IUGR) is an important risk factor of sudden intrauterine unexplained death. Froen, J. F, et al, (2004)Pelletier, D. L, et al (1993, 1995) and Bernstein, I. M, (2000) shows that malnutrition has a far more powerful impact on child mortality by epidemiological method between the age group of 6-59 years. Study focus on 53 developing countries with nationally represented data on child weight-for-age indicate that 56% of the child deaths were attributable to malnutrition’s and 83% were attributable to severe malnutrition.Almond and Mozmudar, (2011) used holy month of Ramadan as a natural experiment to analyses the fetal health during fasting. In case of Michigan sample 1989-2006 for Arab Muslim parents, they found lower birth weights and reduction of male offspring if Ramadan overlapped with first gestation month. A strong positive association was found between utero exposure to Ramadan and disability at an adult age, especially mental or learning disabilities in Uganda Census 2002 and Iraq Census 1997.In addition, they found positive effects wealth, earnings and composition of adult age. No evidence was found for negative selection in conception during Ramadan. As like previous literature major diseases of later life, including coronary heart disease, hypertension, and type2 diabetes originated during consequences of “programming” during intrauterine growth and development in later life. Roseboom, Rooji and Painter (2006), Godfrey, K. M, and Barker, D. J, (2000). Reduction in ovulation rate in female progeny but there is no effect on prenatal exposure of malnutrition on male reproductive development and adult function Rae, M. T, (2002).It can be safely concluded in the light of the above studies that fasting during early stages of pregnancy has a negative effect on fetal health. A study to determine relationship between fasting during pregnancy and birth weight relationship was conducted in Iran for a sample of forty-three hundred women by The sample was divided into four groups that is fasting, non-fasting group. They did not find any kind of significant impact on birth weight of infant in fixed no of days fasting and non-fasting group, other than second trimester with insignificant results. They also said to do fast in first trimester was more in comparison of other trimester. Arab and Nasrollahi, 2001.Cohen and Kim, 2009 used aggregated data from the Behavioral Risk Factor Surveillance System (BRFSS) with special module regarding weight loss. To reduce weight during pregnancy is a high risk for both mother and baby, evidence found that tendency to reduce weight is higher in the age group of 35-44 years, most probably, the pregnancy is unwanted and they are unaware about her conception. Franko et al, 2009 said about 20 million of the children were born as low birth weight in developing countries as a main reason of child mortality or many other infective illness. Oxygen and glucose supply during early pregnancy period is so essential for embryonic development and “poor malnutrition at this stage produces offspring’s with higher blood pressure” Gluckman and Hanson, 2005. Kraemer, 2000 found very surprisingly finding regarding fetal and neonatal mortality higher among girls in Chinese-American also with poor health condition after birth. Malhotra et al. (1989) studied the metabolic changes during Ramadan for a sample of fasting eleven pregnant women of Asia. The sample was compared with the control group of normal mothers observing fast. There was a significant fall in the glucose, insulin, lactate and carnitine and a rise in, non-esterified fatty acid, triglyceride and 3-hydroxybutyrate none of the fasting mothers from control group had a normal biochemical reading at the end of fasting. In a cohort study of 70 Jordanian students on different anthropometric parameters and they found Ramadan has a significantly lower impact in comparison of pre-Ramadan, another important results is that after 2 weeks of Ramadan body weight and other parameter have a tendency to retrieve pre-Ramadan status but still lower significant impact before pre-Ramadan. Ramadan fasting on serum lipid levels may be closely related with nutritional diet and biochemical response to starvation Mansi, 2007.Restricted maternal nutrition is associated with higher risk of neonatal admission in SCBU Mirghani and Hamud, 2006. In a study conducted in UAE by Mirghani et. al. (2004) of health women observing Ramadan at a thirty weeks of gestation period with a control group of non-fasting women to determine the fetal biophysical profile found significant differences among the fetal bio profile of fasting and non-fasting mother. The study concluded that fetal breathing movement are reduced when mother is fasting on the same day. During pregnancy period highly recommended by doctors “Eat small to moderate-sized meals at regular intervals, and eat nutritious snacks”. This is the best way to get proper nutrition requirement for you and your baby. Institute of medicine, 1992: 45. The health effects of fasting on pregnant women may further be gauged by a comparative study conducted by Metzger et al. 1982 documented a set of divergent metabolic changes on conceived mother who skipped breakfast especially on second trimester. They studied the impact of Ramadan fasting among twenty-seven non-pregnant and twenty-one pregnant women with the same characteristics, of “circulating fuels and glucose regulatory hormones.  The level change drastically when overnight fasting was extended to the following afternoon in pregnant women”. Further, the level of plasma glucose and alanine was lower among pregnant women after twelve hours of fasting. These kinds of changes are termed as ‘accelerated starvation’, which are prone to impact the cognitive functions negatively Rizzo et al., 1991.Kiziltan et. Al (2005) analyzed the nutritional status of the pregnant fasting mothers during Ramadan and compared them with a control group of non-fasting mothers. The weight gain and energy intake was lower in the fasting pregnant mothers compared to the control group during third trimester. The percentage of protein for first and second trimester and carbohydrates for all trimester was higher in fasting mothers. They observed a slight increase in the fasting blood glucose, serum total cholesterol high-density lipoprotein-cholesterol and triglycerides. The study concluded that there were no adverse nutritional effects of Ramadan on fasting mothers. In a natural experiment of Chinese famine 1959-1961 by using the 1% sample of census 2000 they found if the fetal exposure to acute malnutrition with many demographic and exogenous demographic characteristics reduces the birth of male offspring Almond et al, 2007.Asking et al, 1999 investigate the Swedish population-based study to examine all women between 1987-95, who faced hyperemesis gravidarum during pregnancy and compared their sex ratio. Results shows that those women’s they faced hyperemesis gravidarum during early pregnancy have a positive association of female offspring. No evidence was found during second and third trimester.

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