ABSTRACT
Although the health effects of Ramadan fasting during pregnancy are still unclear, it is important to identify the predictors and motivational factors involved in women's decision to observe the fast. We investigated these factors in a cross sectional study of 187 pregnant Muslim women who attended antenatal care visits in the Budi Kemuliaan Hospital, Jakarta, Indonesia. The odds of adherence to fasting were reduced by 4% for every week increase in gestational age during Ramadan [odds ratio [OR] 0.96; 95% confidence interval [CI] 0.92, 1.00; p = 0.06] and increased by 10% for every one unit increase of women's prepregnancy body mass index [BMI] [OR 1.10; 95% CI 0.99, 1.23; p = 0.08]. Nonparticipation was associated with opposition from husbands [OR 0.34; 95% CI 0.14, 0.82; p = 0.02] and with women's fear of possible adverse effects of fasting on their own or the baby's health [OR 0.47; 95% CI 0.22, 1.01; p = 0.05 and OR 0.43; 95% CI 0.21, 0.89; p = 0.02, respectively], although they were attenuated in multivariable analysis. Neither age, income, education, employment, parity, experience of morning sickness, nor fasting during pregnancy outside of Ramadan determined fasting during pregnancy. Linear regression analysis within women who fasted showed that the number of days fasted were inversely associated with women's gestational age, fear of possible adverse effects of fasting on their own or the fetal health, and with opposition from husbands. In conclusion, earlier gestational age during Ramadan, husband's opinion and possibly higher prepregnancy BMI, influence women's adherence to Ramadan fasting during pregnancy. Fear of adverse health effects of Ramadan fasting is common in both fasting and non-fasting pregnant women
ABSTRACT
Myocardial infractions at different locations have been related to different sets of risk factors. This study was designed to examine the association between cardiovascular risk factors and specific coronary artery calcification [CAC]. The study population comprised 573 postmenopausal women selected from a population-based cohort study. Established vascular risk factors were measured. The women underwent a multi detector-row computed tomography [16-MDCT] [Philips Mx 8000 IDT 16] to assess coronary calcium. The Agatston score was used to quantify coronary calcium. Logistic regression models were utilized to assess the relations. The prevalence of coronary artery calcification [Agatston score >0] was 61.5% [n= 348]. CAC was most common in the left anterior descending [LAD] artery with a prevalence of 43.9%; and the rates of prevalence in the right coronary arter [RCA], the circumflex [LCX], the left main artery [LM], and the posterior descending artery [PDA] were 23.1%, 19.4%, 15.8%, and 0.3%, respectively. In the multivariate regression models, age was predominantly related to the calcification in the LAD and LCX, low density lipoprotein to calcification in the LAD, and cholesterol to the calcification of the RCA. Hypertension and systolic and diastolic blood pressure were related to the calcification of the LCX, whereas smoking was predominantly related to the calcification of both LAD and RCA. Finally, age, body mass index, and systolic blood pressure were significantly related to teh classification in the LM. Our findings showed that the consequences of elevated risk factor levels on the development of atherosclerosis appeared to be different across the segments of the coronary arteries