Impact of Prenatal Exposure to Fasting on Cognitive Development of Children

Abstract

A number of recent studies have shown that prenatal nutritional shocks have a long-lasting impact on health, cognitive ability and adult outcomes. This study looks at the impact of exposure to the month of fasting on the academic achievement of currently enrolled children aged from 5-15 years in order to develop policies aimed at promoting maternal nutrition during early months of pregnancy. The study has used exposure to the month of fasting of pregnant Muslims as a natural experiment to analyze this impactsince it is possible that there is a change in nutritional intake during this period. The study usedthe LEAPS (Learning and Educational Achievements in Punjab Schools) study data collected by the World Bank for different regions of Punjab, Pakistan. As actual fasting behavior of pregnant Muslims cannot be observed, the study applied“intention to treat” approach;this permits measurement of impact in the presence of non-compliance and endogenous fasting behavior, as the only requirement is the assumption that timing of Ramadan is exogenous to the pregnancy, so that women have not timed their pregnancy to avoid Ramadan. Results show that up to now children who were exposed to the month of fasting in early pregnancy had a lower score compared to those who were not exposed. We found that those students who were exposed in early pregnancy had a lower score in English even after controlling for anthropometric measures and school and teacher fixed effects. On Urdu tests, students who were exposed in the third month had a lower score while students who were exposed in the ninth month had a higher score than those were not exposed. Results for mathematics test scores were similar; a lower test score was observed when exposure occurred in the third month of pregnancy while test scores were higher when Ramadan coincided with the last month of pregnancy. Overall the study concludes that maternal nutrition, particularly during the early months of pregnancy, should be a public health priority to ensure that all children reach their potential.