Reviewer ’s report  
 
Title: Changes in work behavior during pregnancy in rural Anhui, China from 2001 -03 to 2009: 
a population based cross -sectional study  
 
Version: 0 Date: 29 Dec 2015 
 
Reviewer: Matteo  Bonzini  
 
Reviewer’s report:  
 
Neupane and colleague presented a deeply revised version of the manuscript a bout changes in 
work behaviors during pregnancy in rural China.  
 
It is a paper about working condition during p regnancy in developing countries. To have info in 
a setting as Anhui (rural and rapidly developing) is a very precious opportunity, even if paper per 
se present methodological weakness that are very common among surveys conducted developing 
countries.  
 
I really appreciate th e hard work authors performed, trying to take into account the questions we 
raised in the previous paper. They only partially succeeded, but the paper is in general 
substantially improved.  
 
Intro is partially improved with a bit of more  recent paper. The focus on women condition in 
developing and rural contest is now more clearly stated.  
 
Readers now get more possibility to understand how the surveys were conducted. Looking at 
details weakness appeared, some of them not amendable (page 5) . But it could be interesting at 
least to know how any subjects were collected using proxy respondents (see line 89) and (if 
many) if that su bgroup gave different results.  
 
I appreciate to have details about questionnaires used during the two interviews. The question 
about their comparability is crucial and we read that "questions about work behavior were 
identical (see line 110). It could be interesting to know why they changed others parts of survey 
and why. We all know that using the same instrument or scale in a questionnaire that 
dramatically changed in other parts or that modified its "general tasting" could change how 
people answers the same questions. Line 111 seems to contain typos or is not clear.  
 
Results: Table 1 remove last three rows, not compa rable  
 
Discus sion. The observed demographic changes cannot explain per se the dramatic differences in 
the proportion of women tha t stopped to work early d uring pregnancy. Even cultural believes 
hardly changed so deeply in a decade. We can observed a sen sibly change in medium income, 
but a comparison with other studies in similar rapidly growing economy is lacking. I guess that 
only a different policy about maternal safety and health can be associated to such a radical 
change in maternal behaviors. It is a shame that we have no data about that.  
So we cannot assume that a particular and specific change in policies could explain what 
researchers observed Finally I suggest a native English final review to improve paper readability.  
 
Conclusion the paper impro ved. It is of limited interest because it describes a phenomenon that is 
numerically massive, but it is not able to individuate reason underlying that. So we cannot 
assume that a particular and specific change in policies could explain what researchers obs erved. 
The generalizability of such a situation is thus currently limited, but however it is important to 
know that this happens in Anhui to compare it with future stud ies conducted in other rapidly 
developing contexts.  
 
As a suggestion for further researc h, given the unusual change in the proportion of ma ternal 
leave during pregnancy, I think Anhui province would be a precious setting to study maternal 
outcomes (preterm delivery, birthweight, pre -eclampsia). In particular to investigate if changes in 
maternal behaviors lead to better maternal and fetal outcomes. I think it is not so probable to 
observe that, and such a result could be of greater interest.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in  the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in t he manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation  that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relati ng to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the  above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
No competiting interest about that paper  
 
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