As Long as the Breath Lasts. In Utero Exposure to Ramadan and the Occurrence of Wheezing in Adulthood

Abstract

While prenatal exposure to Ramadan has been shown to be negatively associated with general physical and mental health, studies on specific organs remain scarce. This study explores whether Ramadan during pregnancy has impacts on the occurrence of wheezing, a main symptom for obstructive airways diseases. Using data from the Indonesian Family Life Survey collected between 1993 and 2008 (waves 1 to 4), we compare wheezing occurrence among adult Muslims who had been in utero during Ramadan with adult Muslims who had not been in utero during Ramadan. Wheezing prevalence is higher among adult Muslims who had been in utero during Ramadan, independent of the pregnancy phase in which the exposure to Ramadan occurred. Moreover, this association tends to increase with age, being strongest in the age groups 45+. This is in line with fetal programming theory suggesting that impacts of in utero exposures often only show after the reproductive age. Particularly strong associations were detected for smokers. The respiratory system of prenatally exposed Muslims thus seems to perform worse in mitigating later ex utero harmful influences such as smoking. This study suggests that exposure to Ramadan during pregnancy may have lasting consequences for adult lung functionality.