Title: The association of parity number with multimorbidity and polypharmacy among
Iranian women in the Azarcohort: A cross-sectional study
Version: 3 Date: 13 Apr 2023
Reviewer's report:
The revised is much more improved, questions were properly answered.
There are many words attached to other. Please correct throughout the  text.
A space is required before all reference numbers.
A space is required after characters such as dot, comma, semicolon, (., : ).
Abstract:
Result: Line 41: enhanced the odds of abdominal obesity
Conclusion:
Line 46: for preventing morbidity and premature mortality among
line 47: among susceptible and highly parous women
Introduction:
Please remove the sentence with reference 18 and move sentence with reference 13 after
reference 8.
Line 92: remove novel
Patients & Methods:
Line 101-107: please replace with fallowing sentence
In the enrolment phase, 15,006 subjects were recruited. Living in the county for at least nine
months was an inclusion criterion in the Azar Cohort Study. In addition, subjects who were
not able to articulate their own opinions due to severe physical or psychiatric disorders were
excluded from the enrollment phase of Azar Cohort Study. We retrieved the baseline data
pertaining to 8,290 female Shabestar County residents aged 35 to 70. Then, females who had
never experienced menstruation were excluded from this study. Ultimately, 8,286 females were
included in our study. Further details concerning the AzarCohort Study are published elsewhere
[23].
Reproductive history:
Line 125: please delete duration from “pregnancy duration “ and replace it with  pregnancy
number
Multimorbidity:
Line 135 : please remove prostate and replace it with ovarian
Polypharmacy:
Line 142:Please added fallowing sentence after herbal drugs.
Also contraceptives or hormone replacement therapy were counted as drugs in the variable
"polypharmacy.
Anthropometric measurements:
Line 151: Please insert reference for this sentence: Indices signaling abdominal obesity among
our female subjects included WC #88 cm and WHR #0.85 cm, or WHtR#0.5
Statistical analysis:
Why MET was not adjusted in model 2.
Results:
Line177 : please start this sentence from a new paragraph : Findings of regression for the
association of parity number with MM, polypharmacy, and various chronic diseases are
presented in Table 3.
Line180 :   Please attach this sentence to before sentence (not a new paragraph): Compared to
women without parity, women with parity numbers of3–4 (OR: 2.21; 1.84–2.65), 5-6(OR:4.12;
3.36–5.04), 7-8 (OR:5.12;4.04–6.48), ……..had a higher adjusted OR for polypharmacy
(Table3).
Line 191: please added this result “Compared to nulliparous women, women with #9 parities
had a 1.96 times higher OR of COPD after further adjustments (OR: 1.96, 95%CI 1.03–3.75(.”
after this result: Interestingly, after adjusting for confounding factors, the OR of depression in
women with #3paritieswas significantly higher than in nulliparous women.
Line 194:  Please in this result, state adjusted OR not unadjusted :  We found that increasing
parity numbers (especially #5) enhanced the OR of abdominal obesity,WHR#0.85, and
WHtR#0.5. In other words, women with parity numbers#9 had the highest odds of WHR#0.85
(OR:8.96, 6.25–12.86) and WHtR#0.5 (OR:9.97,5.27–18.84).
please do the same format for stating OR and CI like (OR: 1.96, 95%CI 1.03–3.75) or (OR:
1.96, 1.03–3.75) throughout the results.
Discussion:
Line 198: please remove this sentence: “Therefore, we had to justify this observed relationship
usinga mechanism-like manner”
Line 209: please replace this sentence: “Another possible reason ….. access to healthcare;  “
with fallowing sentence:
Another possible reason for the increased MM in women with high parity is that women with
higher parity are more likely to have an unhealthy diet, less physical activity, less favorable
lifestyle (e.g. smoking), and poorer access to health care;
Line 215:  In your study, CVD was not significant in adjusted model. Please remove CVD from
this sentence: Other findings of this study indicated that the prevalence of hypertension and
CVD tended to increase.
Line 223: In your study, CVD was not significant in adjusted model. Please remove sentences
with references 30,31 and 15 from discussion.
Line 263: for preventing morbidity and premature mortality among..
Tables:
Table 1:  P value for mean height not present.
Please replace waist circumference with WC in Table 1 and added WC: waist circumference in
abbreviations in the end of table.