Health

Decline in Birth Rate in the UAE

Dr. Ramya Raj, Specialist Obstetrician and Gynecologist

International Modern Hospital Dubai

Official statistics released by the Ministry of Health and Prevention show a significant decline in the number of births among Emirati citizens over the past decade, prompting concern from a parliamentary committee about the long term demographic and social implications.

Data obtained by Emarat Al Youm indicate that the number of births to UAE citizens fell by 13.55 per cent between 2014 and 2023, from 34,618 in 2014 to 29,926 in 2023.

1)Reasons

1.Later marriages-“Behind every data point is a young couple making decisions about marriage … A working mother balancing ambitions with nurturing. A father wanting to give more time but stretched by economic pressures. These are not only social realities – they are policy challenges, and more importantly, national opportunities.”

2.Health issues- “Even among younger patients, we’re seeing low ovarian reserves, obesity, diabetes and poor nutrition. These all impact fertility. We’re also seeing a sharp rise in secondary infertility among men, often linked to smoking or the use of unregulated performance-enhancing substances.”

3.Lifestyle changes-including increased consumption of processed foods, widespread vitamin D deficiency associated with limited sun exposure, and lifestyle patterns that contribute to hormonal imbalance and conditions like PCOS,Endometriosis.

4.Thoughts on Family size-very personal andcan vary alot depending on values,circumstances,lifegoals. In the past, most Emirati families had five or more children. Now, most couples want two or three. It may seem reasonable, but if you compare it to previous generations, the demographic impact is significant,”

2)yes for sure-“Ten years ago, most of our patients were under 35 and already married,” he said. “Today, we see women in their late thirties and early forties coming in to freeze eggs – not necessarily because they have fertility issues, but because they’re not ready to marry. They’re busy with work or studies.”

3)Fertility declines with advancing age, beginning as early as the middle of the third decade. Women who do conceive at an advanced maternal age (traditionally defined as age 35 years or older) are at greater risk of early pregnancy-related complications including miscarriage, aneuploidy, and ectopic pregnancy. Other obstetric complications linked to older age include gestational diabetes, hypertension, preeclampsia, placenta previa, placental abruption, dysfunctional labor, cesarean delivery, postpartum hemorrhage, and maternal mortality; fetal complications include congenital anomalies, prematurity, growth restriction, macrosomia, and stillbirth. Increased paternal age is also associated with lower fertility, an increase in pregnancy-associated complications and an increase in adverse outcome in the offspring.

4)US data on delayed motherhood are the effect of a strong social pressure: a constant economic and social pressure to delay pregnancy without any perspective to invert this trend . This is a paradox. On one side scientific literature more and more clearly says that the less risky range of maternal age to bear babies is 20-30 years as it is associated with a lower likelihood of non-chromosomal problems in babies and on the other side, people perceive they should postpone pregnancy.Thus, the best age to become parents is a compromise between two poles, and women as well as couples find it hard defending their right to having babies when young.

5)Modern lifestyle refers to the contemporary ways of living, characterized by factors such as sedentary behavior, poor dietary habits, stress, and exposure to environmental pollutants, which can impact reproductive health and fertility.1.A poor diet can significantly impact female fertility. Consuming low amounts of fruits and vegetables can disrupt hormone regulation and ovulation due to the lack of essential nutrients, antioxidants, and fiber. Additionally, a high intake of processed foods can lead to insulin resistance, inflammation, and hormonal imbalances, all of which can negatively impact fertility. Inadequate omega-3 fatty acids can also affect hormone production, ovulation, and embryo implantation. Furthermore, excessive caffeine and sugar intake can disrupt hormone balance, ovulation, and fertility.2. A sedentary lifestyle can lead to insulin resistance and metabolic disorders, which can disrupt hormone regulation and ovulation. However, physical inactivity can lead to chronic inflammation, which can negatively impact fertility and reproductive health.3. Stress can also significantly impact female fertility. .4 .Exposure to environmental pollutants can also significantly impact female fertility. Endocrine-disrupting chemicals (EDCs), such as BPA and phthalates, can mimic or interfere with hormones, disrupting ovulation and fertility. Air pollution, particularly particulate matter (PM), has also been linked to reduced fertility, increased risk of miscarriage, and birth defects. Furthermore, exposure to heavy metals, such as lead and mercury, can disrupt hormone regulation, ovulation, and fertility

6) yes, Long working hours can significantly have impact on fertility by disrupting harmonal balance and leading to various reproductive health issues. Chronic Stress can disrupt hormone production, including cortisol, insulin, and thyroid hormones, which can impact ovulation and fertility. Chronic stress can also delay or prevent ovulation, making it challenging to conceive. Stress can also disrupt the balance of the gut microbiome, which is essential for hormone regulation, immune function, and fertility. In Men its associated with low sperm quality.

7). Despite medical progress, Misinformation around natural conception keeps many couples from conceiving naturally. Busting these misconceptions can help couples identify real pregnancy delay reasons and take the right steps early.

1.Many couples think that having sex at any time can lead to pregnancy. This misunderstanding can lead to disappointment when pregnancy does not happen, even with regular sexual activity.

Fact: Conception only occurs during ovulation, about 12 to 14 days before the next period begins. The fertile window lasts about six days: the five days before ovulation and the day of ovulation.

2.Couples often assume that increasing intercourse frequency directly increases conception probability. This leads to scheduled sexual activity that creates stress and reduces spontaneity.

Fact: Daily intercourse may lower sperm quality and reduce sperm count per ejaculation. Sperm concentration and motility remain optimal with intercourse every two to three days during the fertile window.

3.Popular culture suggests that some positions, especially those that allow deeper penetration or gravity assistance, can increase the chances of fertilisation. Couples often spend time and energy trying these methods that lack clear evidence.

Fact: No medical evidence links sexual positions to conception rates. Sperm reaches the cervix within seconds of ejaculation, regardless of position during intercourse.

4.The common advice to “just relax” implies that psychological stress is the primary pregnancy dilemma. This oversimplification dismisses legitimate medical causes of infertility.

Fact: Stress can affect hormones, but rarely causes infertility on its own in healthy individuals. Managing stress through rest and balanced living supports overall well-being, but does not guarantee conception.

5.Cultural biases and old beliefs place most of the responsibility for fertility on women. This leads to women undergoing extensive testing, while their male partners face little to no evaluation.

Fact: Male factors account for up to 50% of infertility cases. Common male issues include low sperm count, poor sperm motility, abnormal sperm morphology, and complete absence of sperm in the ejaculate. Both partners should undergo evaluation when conception delays occur beyond the expected timeframe.

6.Women experiencing a delayed period no pregnancy often assume conception has occurred. This leads to confusion when pregnancy tests return negative results.

Fact: A delayed period could stem from hormonal imbalance, stress, thyroid issues, or diet changes that affect the menstrual cycle, Polycystic ovary syndrome ,Premature ovarian insufficiency, excessive exercise, substantial weight fluctuations, and certain medications also disrupt menstrual regularity.

7.The widespread belief that fertility ends abruptly at 35 causes panic and hasty decisions. Women abandon attempts at natural conception prematurely based on this arbitrary age marker.

Fact: Fertility decreases with age, but pregnancy is still achievable naturally with healthy habits and timely medical guidance. Egg quantity and quality decline progressively from the late 20s onward, with acceleration after 35 and more decline after 40. Many women achieve successful pregnancies in their late 30s and early 40s without medical intervention.

8.Internet sources promote various home remedies to get pregnant quick, from specific foods to herbal supplements. Couples invest money and hope in unproven methods based on anecdotal claims.

Fact: Remedies like herbal teas or special diets can support reproductive health, but do not guarantee conception on their own. No natural fertility remedies have rigorous scientific evidence proving they cause pregnancy or increase conception rates. While good nutrition supports overall reproductive health by providing sufficient vitamins and minerals, supplements

8)couples advised to Consult Specialist for Medical evaluation is important for couples who experience delay in getting pregnancy longer than 12 months, or six months for women over 35.

9)Assisted reproductive technologies (ARTs):

The landscape of ARTs has undergone transformative changes driven by innovations such as in vitro fertilization (IVF) and egg freezing. These advancements have emerged as powerful tools, granting individuals unprecedented control over their reproductive timelines. ARTs can sometimes inadvertently contribute to a delay in childbearing.

1. For instance, IVF combines eggs and sperm outside the body, enabling fertilization before transferring embryos to the uterus. It can also assure individuals that they can conceive at a later age. This confidence may lead some people to delay starting a family, believing they can always turn to IVF when ready.

2.Similarly, Egg Freezing technique involves extracting a woman’s eggs, freezing them, and storing them until a later time. This innovation is particularly significant for individuals facing medical treatments that may compromise their fertility, such as chemotherapy, or those navigating career trajectories that necessitate delaying childbearing. Egg freezing, a pivotal aspect of ARTs, empowers women by allowing them to preserve their eggs at a younger age when fertility potential is higher. These preserved eggs can be thawed, fertilized, and implanted, offering women a means to extend their childbearing years and pursue life goals before embracing. However, this option can inadvertently encourage women to postpone childbirth while focusing on career advancement or other life pursuits, assuming their fertility remains preserved. In practical terms, consider a scenario where a woman in her late twenties decides to freeze her eggs to ensure her fertility.

With this safety net in place, she may delay starting a family and instead invest more time in her career or personal development, knowing she can rely on her preserved eggs later. While this is a valuable choice, it exemplifies how ARTs, like egg freezing, can influence the timing of childbearing decisions.

By leveraging the advances in reproductive science, these technologies have allowed individuals to conceive beyond what nature’s timeline might otherwise allow. This extension of the biological clock is flexible, as fertility naturally declines with age. However, technological strides have created an avenue for individuals to pursue parenthood later in life, blurring the lines of traditional age-related constraints and offering new horizons for those who wish to optimize their reproductive potential.

10)Early Screening and Medical Consultation to Protect Future Fertility

For individuals planning to delay pregnancy, early screening and medical consultation are crucial to protect future fertility.

• 1.Fertility Testing: It’s recommended to seek fertility testing if you have been trying to conceive for a year or more without success. Early diagnosis can lead to quicker solutions and reduce emotional stress.

• 2.Signs to Seek Evaluation: Look for signs such as irregular or absent periods, painful periods or intercourse, or a history of miscarriages. These could indicate issues with ovulation, hormonal imbalances, or other reproductive conditions.

• 3.Preconception Counseling: Preconception counseling can help women prepare physically, emotionally, and medically for a future pregnancy. It includes a detailed medical review, fertility and cycle discussion, condition management, lifestyle and nutrition guidance, vaccination and infection screening.

• 4.Genetic Testing: Mandatory genetic testing will be introduced as part of the premarital screening program for Emiratis planning to marry, starting early January 2025. This will help identify potential risks of passing on genetic disorders.

• 11)Health awareness before marriage is essential for several reasons:

• 1.Preventive Measures: It allows couples to take preventive measures for potential health risks, ensuring a healthier future together.

• 2.Family Planning: It aids in informed decisions about family planning, including the use of assisted reproductive technologies.

• 3.Early Detection: It enables early detection of health issues, which can lead to prompt medical intervention and management.

4.Genetic Testing: In some regions, genetic testing is part of the premarital screening process, which can significantly improve family planning by reducing congenital disabilities.

• 5.Public Health: In the UAE, premarital screening is mandatory to protect public health by detecting and addressing infectious and hereditary diseases before marriage.

Couples should consider these factors when deciding to undergo premarital health screening to ensure a healthy and informed marriage.

• 12)Young couples trying to balance work and starting a family can benefit from the following advice:

• 1.Communicate openly: Discuss work and family needs with your partner, listen with empathy, and create joint routines that deepen trust.

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• 2.Prioritize quality time: Make time for regular, quality time together and small, shared moments that reinforce love, safety, and closeness.

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3.Set boundaries: Establish boundaries for work to avoid being overwhelmed and to ensure both partners feel supported.

4.Limit nonessential activities: Minimize time spent on activities that do not contribute to your work or family responsibilities.

5.Learn to say no: Be prepared to say no to tasks that may take away time from work or family.

By implementing these strategies, young couples can create a harmonious balance that allows both to thrive in their careers and personal lives.

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Health

Beyond Uniforms and Lunchboxes: Is Your Child Healthy and Ready for School?

By Dr. Mamata Bothra, Specialist Pediatrician and Neonatologist, International Modern Hospital, Dubai

With schools reopening on August 25, parents across the UAE are busy preparing uniforms, books, shoes and lunchboxes. But before the school bag is packed, it is worth asking one more important question: Is my child healthy and ready for the new academic year?

As a pediatrician and neonatologist, I encourage parents to use the remaining days before school as an opportunity for a simple health review. This does not mean carrying out a long list of unnecessary medical tests. Instead, it is about identifying any health concerns that could affect a child’s learning, energy, development or overall well-being.

Start with vaccinations and medical needs

Begin by checking your child’s vaccination record. Make sure all routine vaccinations are up to date and that no recommended doses have been missed. Parents should also speak with their child’s doctor about the seasonal influenza vaccine.

If your child has a chronic medical condition or requires regular medication, ensure prescriptions are current and that the school has the necessary medical information, medicines and emergency action plan.

A routine pediatric check-up can also be valuable, particularly if your child has not been assessed recently. During the appointment, the pediatrician can evaluate growth, height, weight, blood pressure, physical development, nutrition and general health.

It is also an opportunity to discuss concerns that may have been postponed during the holidays, including recurrent headaches or abdominal pain, constipation, frequent infections, breathing difficulties, snoring, fatigue, poor appetite or unexplained changes in behaviour and school performance.

Preventive pediatric visits should not focus solely on vaccinations. They also provide an opportunity to discuss a child’s learning, behaviour, development, emotional health and any age-appropriate screening needs.

Does your child need tests for iron or vitamin deficiencies?

Iron deficiency deserves particular attention because it can affect a child’s energy, concentration and neurodevelopment. However, this does not mean that every healthy school-aged child needs to undergo a large “vitamin panel” before returning to school.

The decision to perform blood tests should be based on the child’s age, diet, growth, symptoms and individual risk factors.

Children who follow restrictive, vegetarian or vegan diets, have poor nutrition, consume excessive amounts of milk, have a chronic illness or are not growing as expected may require further assessment. Persistent tiredness, pale skin, weakness and difficulty concentrating can also indicate the need for medical evaluation.

When testing for possible iron deficiency is clinically indicated, particularly in adolescents, a complete blood count and serum ferritin test may be useful.

Similarly, testing for vitamin D, vitamin B12 or other nutritional deficiencies should be guided by the child’s medical history, diet, symptoms and clinical examination—not performed routinely for every child.

Do not overlook vision and hearing

A child who cannot see the board or hear the teacher clearly may appear inattentive when the real problem is sensory.

Possible signs of a vision problem include squinting, sitting very close to screens, rubbing the eyes, experiencing frequent headaches, holding books unusually close, struggling to read, turning the head to one side or showing an unexplained decline in school performance.

For hearing, parents should watch for frequent use of the word “What?”, increasing the television volume, difficulty following instructions, failing to respond when called or a history of recurrent ear infections.

Not every concentration problem is an attention disorder. Before labelling a child as inattentive, we should first make sure the child can see clearly, hear properly and sleep well.

Dental health affects learning too

A dental check-up is worthwhile if your child has not visited a dentist recently, particularly if there is toothache, sensitivity, bleeding gums, persistent bad breath or visible tooth decay.

Dental pain can interfere with eating, sleeping, concentration and school attendance.

Parents should also remember that a school lunchbox does not need to become a travelling sweet shop. Encourage children to brush regularly with fluoride toothpaste and limit frequent sugary snacks and drinks.

Reset the body clock before school begins

If your child’s bedtime has gradually moved towards midnight during the holidays, do not expect them to fall asleep at 9pm on the night before school.

Start adjusting bedtime and wake-up time gradually before classes begin. School-aged children generally require nine to 12 hours of sleep each night, while teenagers usually need eight to 10 hours.

Insufficient sleep does not always appear simply as tiredness. In some children, it may cause irritability, hyperactivity, poor concentration, mood changes or behavioural difficulties.

Prioritise balanced food and hydration

A nutritious breakfast and balanced diet can help children begin the school day with energy and concentration. Aim to include a variety of protein, whole grains, fruits and vegetables while reducing highly processed food and sugary drinks.

Hydration is especially important in the UAE’s climate. Send your child to school with a water bottle and encourage regular drinking throughout the day rather than waiting until they feel very thirsty. Water should remain the main drink.

A practical back-to-school health checklist

Before August 25, parents should consider the following questions:

Vaccinations: Are all routine vaccinations up to date?
Growth: Is my child’s height and weight progressing appropriately?
Iron and nutrition: Is there a dietary risk or unexplained fatigue that requires assessment?
Vision: Can my child see the board and read comfortably?
Hearing: Can my child hear clearly and follow instructions?
Dental health: Is there any pain, sensitivity or untreated dental problem?
Sleep: Has my child’s routine returned to school timings?
Food and water: Is my child eating a balanced diet and drinking enough water?
Chronic conditions: Are medicines, prescriptions and school action plans updated?
Development and behaviour: Have there been changes in learning, concentration, mood or behaviour that require attention?

Parents do not need to panic or turn the back-to-school season into a medical examination marathon. The objective is not to find a problem in every child. It is to ensure that an existing concern does not go unnoticed.

A new uniform may prepare a child for the classroom, but adequate sleep, balanced nutrition, clear vision, good hearing, healthy teeth and timely medical care prepare that child to learn.

This year, before asking, “Have you packed your school bag?”, perhaps ask one more question:

“Are you healthy, rested and ready for the year ahead?”

Health

Back to the Heat: Why Returning to the UAE Can Leave Holidaymakers Feeling Exhausted

Returning to the UAE after spending several weeks in a cooler destination can leave some travellers feeling unusually tired, sluggish or generally out of sorts. According to a family medicine specialist, this is often part of the body’s natural process of readjusting to extreme heat and humidity.

Dr. Renuka Ramasamy, Specialist in Family Medicine at International Modern Hospital Dubai, explains that spending time away from a hot environment can temporarily reduce some of the body’s heat adaptations.

“When someone spends a couple of weeks in a much cooler climate, some of the body’s adaptation to extreme heat can begin to diminish,” she says. “Heat acclimatisation influences how efficiently we sweat, regulate our core temperature and manage the cardiovascular strain caused by hot weather.”

These adaptations can start declining within days or weeks when a person is no longer regularly exposed to high temperatures. When they return suddenly to the UAE’s summer conditions, their body must work harder to maintain a safe and stable core temperature.

More blood is directed towards the skin to release heat, sweating increases and the cardiovascular system must compensate for the additional strain. As a result, some people may initially feel unusually tired, physically heavy, less energetic or generally unwell.

“It is essentially a period of re-acclimatisation,” Dr. Ramasamy explains. “Fortunately, someone who was previously accustomed to the UAE climate will generally readjust more quickly than a person experiencing this level of heat for the first time.”

Heat, dehydration and disrupted routines

The sudden change in temperature is rarely the only reason people feel unwell after returning from holiday. Heat, humidity, dehydration, poor sleep and changes to daily routines can combine to make the transition more difficult.

In hot and humid conditions, sweating and fluid loss increase. At the same time, high humidity makes it harder for sweat to evaporate from the skin, reducing the body’s ability to cool itself efficiently.

Even relatively mild dehydration can contribute to fatigue, headaches, dizziness and difficulty concentrating.

“Travel may also disrupt sleep, meal times, exercise habits and normal daily routines,” Dr. Ramasamy says. “People can arrive home already tired or inadequately hydrated and then immediately expose their bodies to considerable heat stress.”

Certain groups are more vulnerable to the effects of high temperatures. These include older adults, young children, pregnant women, outdoor workers and people undertaking strenuous outdoor exercise. Individuals with chronic medical conditions and those taking medications that affect hydration, sweating or temperature regulation should also be particularly cautious.

Give the body time to readjust

During the first few days back in the UAE, people should allow their bodies to gradually readjust instead of immediately returning to a demanding routine.

Drinking water regularly throughout the day is important, rather than waiting until intense thirst develops. People who are sweating heavily may also need to replace electrolytes. However, those with heart or kidney conditions, or who have been advised to restrict their fluid intake, should follow their doctor’s individual recommendations.

Restoring a regular sleep and meal schedule as soon as possible can also support recovery. Fruits, vegetables and other water-rich foods may help maintain hydration, while excessive alcohol consumption should be avoided because it can worsen dehydration.

Exercise should initially be lighter, particularly when performed outdoors. Strenuous physical activity should be avoided during the hottest part of the day, and both the intensity of exercise and the amount of time spent outdoors should be increased gradually as heat tolerance returns.

“The body needs time to readjust,” Dr. Ramasamy says. “People who are not fully acclimatised should reduce the intensity and duration of outdoor exercise during their first week back in a hot environment.”

When symptoms require medical attention

Although mild tiredness and reduced energy may be part of normal re-acclimatisation, people should not automatically dismiss more serious symptoms as a consequence of returning from holiday.

Significant dizziness, fainting, confusion, persistent vomiting, severe weakness or other concerning symptoms may indicate heat-related illness and require prompt medical assessment.

“It is important to distinguish normal readjustment from possible heat illness,” Dr. Ramasamy warns. “Severe or persistent symptoms should not simply be attributed to coming back from holiday.”

For most healthy people, careful hydration, adequate sleep, lighter exercise and gradual exposure to outdoor heat can make the transition back to the UAE climate safer and more comfortable.

Dr. Renuka Ramasamy
Specialist in Family Medicine
International Modern Hospital Dubai

Health

NMC Speciality Hospital, Al Nahda successfully treats Rare case of Guillain – Barré Syndrome in an 11 – Month old Infant

Dubai, UAE – A multidisciplinary medical team at NMC Specialty Hospital, Al Nahda has successfully treated an 11-month-old infant diagnosed with Guillain–Barré syndrome (GBS), specifically acute motor axonal neuropathy (AMAN), variant, enabling the infant to make a complete recovery.

The infant, who was previously healthy, was brought to NMC Specialty Hospital after developing severe irritability and an inability to bear weight following a recent viral illness. Recognising that these symptoms could indicate a serious underlying neurological condition, specialists initiated a comprehensive assessment, leading to the diagnosis of acute motor axonal neuropathy (AMAN), a rare variant of Guillain–Barré syndrome.

Guillain–Barré syndrome is an autoimmune neurological disorder in which the body’s immune system mistakenly attacks the peripheral nervous system. While it can affect individuals of all ages, it is rarely reported in infants younger than one year often making diagnosis particularly challenging.

The case was led by Dr. Krupa Torne, Paediatric Neurologist, and involved close collaboration among experts from Paediatrics, Neuroradiology, Neurophysiology, Physiotherapy and Nursing. The coordinated efforts of the multidisciplinary team enabled a prompt diagnosis and immediate initiation of treatment with intravenous immunoglobulin (IVIG) therapy, which is considered one of the most effective interventions for Guillain–Barré syndrome when administered early.

“The rarity of Guillain–Barré syndrome in infants can make diagnosis difficult, as symptoms may initially be mistaken for more common childhood illnesses,” said Dr. Krupa Torne. “In this case, the early recognition of neurological symptoms, combined with rapid multidisciplinary assessment and treatment, played a crucial role in achieving an excellent outcome. It highlights the importance of maintaining a high index of suspicion for neurological conditions even in very young children.”

Following treatment, the infant was closely monitored and underwent physiotherapy to support recovery and mobility. Over the following weeks, the infant demonstrated steady neurological improvement, regaining strength and motor function.

At the eight-week follow-up appointment, the infant was able to walk independently and showed a completely normal neurological examination, marking a full recovery.

The successful outcome underscores the importance of access to specialist paediatric neurological expertise and integrated multidisciplinary care in managing complex and rare childhood conditions.

“This case reflects the strength of collaborative care and the advanced capabilities available at NMC Specialty Hospital, Al Nahda,” said Dr. Torne. “When specialists across disciplines work together seamlessly, we can deliver timely, evidence-based treatment that significantly improves outcomes for our youngest and most vulnerable patients.”

The infant’s parents expressed their heartfelt gratitude to the entire medical team, acknowledging the compassionate care, clinical expertise and unwavering support that helped their infant make a full recovery.

NMC Specialty Hospital, Al Nahda continues to provide comprehensive paediatric care supported by advanced diagnostic capabilities and specialised clinical expertise, helping patients with both common and complex conditions achieve the best possible outcomes.