Title: Career Advancement and Fertility Intention among Working Women in Japan: A Cross-
Sectional Survey Study
Version: 3 Date: 23 May 2025
Reviewer's report:
This is a valuable study that could serve as a basis for examining perceptions of two major life
events—continuing employment and pregnancy/childbirth—and considering future measures.
To address this social issue that deserves attention both in Japan and internationally is also
consistent with the scope of the BMC Women’s health. However, there are significant concerns
regarding analytical models and the assumptions. Please consider the following comments.
[Introduction]
#I understand that it is difficult to set fertility rate as an main outcome in this type of study.
However, it is important to explain how fertility intention can explain actual fertility rate to be
based on the previous studies. In addition, please provide more detail information to set fertility
intentions as the outcome in this study.
[Methods]
#From line 100, it is described that 3,425 people participated in this study, but this refers to the
number of people analyzed. Please clearly state the original number of participants.
#A more detailed explanation is needed to demonstrate that the definitions and categorization
of “completion group”, “no fertility intention group”, and “fertility intention group” in Fig. 1
are appropriate.
#If this study aim is to identify factors related to fertility intentions and promote the
implementation of measures to address them, rather than grouping respondents in this way, I do
not think this grouping in Fig 1 is appropriate. Rather, participants should be stratified according
to whether they have children or a partner, and the factors associated with fertility intentions
should be identified for each group. At least, it would be better to give more consideration to
the fact that one of the main causes of the declining birthrate is the increase in the number of
unmarried people. Furthermore, does the no-fertility intention group include women who had
fertility intentions in the past but gave up due to circumstances and so on? These points concern
the definition of the main outcome in this study and is considered to be the most important issue
in interpreting the results obtained in this study.
#From line 135#, the reason for excluding standard working hours from the analysis is explained.
However, working hours are an important indicator when considering work-life balance. Is it
possible to include standard working hours in the analysis by taking measures such as treating
inappropriate responses as missing? Would the results be the same if this indicator was included
or excluded from the analysis?
#It is often said that having children is related to income. However, income was not taken into
consideration in this study. I would like to know why the authors did not include information
on the annual income or household income of the participants.
[Results]
#Regardless of whether it is significant or not, please enter the actual p-value in the table instead
of *** in table 1. While the odds ratios and confidence intervals are shown in Table . I think it
is not necessary to describe p-values. And then, *** is written in two places: the middle column
and the right column in Table 2. Please explain what it means.
[Discussion]
#Since this study focused on working women, it can be inferred that the population included
women who wanted to continue working but became full-time housewives and were therefore
excluded from the study. How would you consider this point?
#Since the study focuses on working women, it can be assumed that women who have already
given up their careers to become housewives due to marriage or childbirth have been excluded
from the population in this study. How would you consider this point?
#In addition, if the definition of the target group changes, the analysis results and discussion
may also change significantly.