Title: Social distancing and mental health among pregnant women during the coronavirus
pandemic
Version: 1 Date: 29 Nov 2022
Reviewer's report:
Abstract:
Your results section in the abstract would benefit from some numerical outcome data (such as
strength of the association and p-values).
Your results section in the abstract does not mention the depression results.
I would recommend that your abstract conclusion statement be specific to anxiety (rather than
“mental health”), since that is the primary finding.
Background:
There is a word missing in line 43.
Missing period in line 56.
Overall, the Background seems rambling and disjointed. It reads as if sentences from an
annotated bibliography have been forced into paragraphs that aren’t cohesive. It is missing the
application of this knowledge to the current study and the gap in the literature that this study
fills. I’m left wondering where this study contributes to the knowledge in this field given the
extensive nature of the previous findings and the lack of a clear statement of the gap which
this study fills. I would recommend that you outline the key points you wish to make (what is
the story you are trying to tell?) and then organize your Background section according to that
outline. A clear statement of purpose that defines that gap in the literature and how your study
reduces or eliminates this gap should conclude the Background.
Methods:
The total number of surveys was not initially clear to me. I would recommend making those
details a bit more clear in the Methods.
Lines 109-112: This sentence is confusing and grammatically incorrect. Recommend rewriting
to follow the same style and paragraphs that follow.
For the social distancing questions, what was the time period participants were being questioned
about? The duration of COVID, previous 30 days, previous week, etc.?
The GAD-7 asks about time periods longer than a week. If the average time to follow-up
response was 1.6 weeks, then how did you statistically account for the non-independence of
these measures?
Analysis:
Lines 157-158, what are you referring to with “prospective measure”?
This section needs more detail. One should be able to recreate all the steps of the analyses,
including how variables were calculated, from this section.
Results:
Please provide more details so that the reader does not have to go to the tables for every number.
The results section should contain all relevant statistics and p-values. It currently contains no
statistics and 1 p-value.
Line 165, which categories? This statement is confusing, and I would recommend rewording
here and below.
Discussion:
Your results rely exclusively on a self-created measure only administered at baseline. And since
baseline was conducted throughout the study period, there is a strong temporal effect on this data
that is not accounted for. You are unable to analyze the within-subjects changes that may have
been uncovered if these key questions had been asked at follow-up. This is a serious weakness
of the study.
The limitations section of the discussion needs to be greatly enhanced. Strengths and limitations
are intermixed in a single paragraph.
You state that a strength of the study is “unselected recruitment.” That is simply another name
for a convenience sample, and that is a weakness of the study, not a strength.
Unvalidated instruments were also used, and this is left unstated as a limitation. In addition, no
measures of the internal consistency (e.g., Cronbach’s alpha) of the un-validated measures were
included in the results.