Reviewer ’s report  
Title: Investigation of the association between quali ty of life and depressive symptoms during  
postpartum period: A correlational study.  
 
Version: 1 Date: 28 Mar 2017  
 
Reviewer: Touran Shafiei  
 
Reviewer's report:  
Thank you for the time and effort you have put into revising the manuscript; there is a 
considerable  improvement.  However there are still a number of issues which require 
clarification and/or further work before being appropriate for publication.  
 
Overall the manuscript requires some editing.  
 
Abstract line 7, please add 'by' before 'approximately 3%... '  
 
Abstract line 46, please change the word 'suffered'; make the sentence '9.9 % of participants 
experienced postpartum depression symptoms"  
 
Abstract line 49 and 56, please use 'association' instead of 'correlation'; correlation is generally 
used when th ere are continuous data and when referring to a linear trend; your data (e.g. 
experiencing postnatal depression, place of residence, education) are all categorical data.  
 
Abstract -conclusion, line 17 -19, it states "postpartum depression provokes the qualit y of life of 
women, both during and after pregnancy"; how postpartum depression can affect the quality of 
life during pregnancy; furthermore, the aim and findings of this study was about postnatal period, 
so couldn't conclude about the quality of life duri ng pregnancy.  
 
Background line 56 -59, please add a reference for the statement; 20% prevalence rate is higher 
that the reported rate in the recent systematic reviews.  
 
Page 4, line 1 -7, it seems that references 8 and 9 are not relevant to this text; please  add a 
relevant reference. Similarly the reference 12 (line 31) is not the right reference for the WHO 
definition of the quality of life.  
 
Page 5 line 36 -39, please add the aim from the abstract.  
Page 5 line 59, I'd like to suggest using 'research participants' instead of 'research volunteers'  
Page 6 line 1, it's mentioned that participants were recruited 'via word of mouth'; could you 
please provide more details on how participants were approached /invited and how were recruited 
to the study.  
 
Page 6 line 3 -4, one of the inclusion criteria was that participants to be interviewed between 2nd 
day and 12 weeks postpartum. Does it mean that not all participants were interviewed on day 3 
or 4 after birt h as mentioned in the abstract (line 34) and methods (page 5, line 54)? Please 
clarify and correct the abstract and the method accordingly.  
 
Page 6 line33 -35; "questionnaires were distributed at a period of 3 months' time"; did 
participants completed a qu estionnaire at the same time they were recruited?  
 
Page 6 line 12 -16, I'd suggest to move this to the beginning of the 'methods'  
Page 7 line 32, please change '1000' to '100'  
Page 7 line 46, change 'qualitative' to 'quantitative'  
Page 8 line 15, '17% of th e participants declared not having a very good relationship with their 
husband'; please add the figures in the table 1  
Page 8 line 22; in addition to the percentage please add the number of women who scored high 
on the EPDS.  
Page 8 line 22; why a cut -off 1 2.5; there is not usually a fraction for the EPDS score; did you 
mean a cut -off greater than 12?  
Page 9 line 39 and line 47, only 2 women had chronic disease which is very small number for 
conducting the analysis; please also remove this from the table 4  
Page 10 line 19 and Table 5, please change 'Mental Health' to 'Emotional wellbeing' to be 
consistent with the SF -36 items mentioned in the Methods.  
Page 12 line 17, please replace 'suffered' with 'experienced'  
Page 12 line 22, the discussion compares the ra te of PPD in this study with other study; however 
this should be noted that the study of Gonidakis reports period prevalence of postnatal depression 
within the first 6 months.  
Page 13, line 29 to 59; the discussion is not clear; please rewrite this sectio n specifically relevant 
to the study findings.  
Page 14 line 12; it states that size of the study participants was the strength of the research; there 
is no information of the study power and sample size calculation in the manuscript; please add 
the details  in the methods.  
 
Different spelling has been used for 'caesarean' throughout the paper; please be consistent.  
 
Conclusions page 14 line 39, as mentioned for the abstract -conclusion, the conclusion should not 
mention about the quality of life during pregna ncy.  
 
Are the methods appropriate and well described?  
If not, pl ease 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.  
Unable to assess  
Are the conclusions drawn adequately suppo rted by the data shown?  
If not, please explain in your comments to the authors.  
Unable to assess  
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 the manuscript:  
Needs some language corrections before being published  
Declaration of competing interests  
Please c omplete 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 o f 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 ap plying 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 relating to the content of the manuscript?  
5. Do you have any other f inancial 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.  
 
'I decl are that I have no competing interests'  
 
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