Title: Reproductive Health of Syrian Refugee Women in Lebanon: A Descriptive Analysis of
the Sijilli Electronic Health Records Database
Version: 6 Date: 29 Nov 2022
Reviewer's report:
Thanks for again putting considerable effort to respond to reviewers earlier comments. This led
to further improvement. However, some phrases and issues still  need attention, like:
line 210: "Comparison of age at onset of data collection and at first pregnancy between the three
groups were significant." Not clear what 'comparison of age at onset of data collection' means.
Leaving that out the phrase needs anyway to be edited: something like:  "Comparison of age at
first pregnancy between the three groups shows  significant differences"
line 302: "The rate of C-section deliveries has significantly increased for more than the double
between deliveries in Syria only and those in Lebanon only". 'for more than the double' is not
correct - could be changed into 'to more than double'
line 324: "Among the first pregnancies in each group, still normal vaginal delivery was more
common among pregnancies in Syria only (Table 3). Abortions were still more common in
Lebanon compared to pregnancy cases in Syria. Still, the most common method of abortion in
first abortion cases was no surgical or medical interventions in Lebanon. While abortion cases
that happened only in Syria reported either no interventions or used medical interventions to
abort equally. "
This paragraph has various issues, and also leads to some queries regarding table 3:
-the repeated use of the word 'still' - probably is meant as 'also' (i.e. just like the all pregancy
category)?
-The sentence starting with 'while' - use of while is not correct here. But, more important, the
statement is unclear as to how it relates to the table.
-This then leads to questions around table 3:
----how does the  'abortion methods' relates to the abortions data in the section above (delivery
methods)?
----what were numbers for first pregancies ? - this is not given, while there is a row with missing n
----would it not make more sense to have the heading for 2nd and 3rd column not read 'all
pregnancies' but rather pregancies in Syria / Lebanon only?
line 332: "3.2. Syria only versus Lebanon only delivery cases among Mix group". Seems to
make more sense to state 'Syria versus Lebanon delivery cases among Mixed group
line 334  "almost the double " should be 'almost double'
Line 418:" Only quarter the ever-pregnant SR women "  Better: Only a quarter of the ever-
pregant SR women"
Line 461: " women are indicatives "  Better: 'are indicators'
Line 472: "It is estimated that more than 500 women and adolescent girls die daily due to
complications related to pregnancy and childbirth in humanitarian and emergency settings"
Assumingly 500 deaths worldwide? What is the purpose of this sentence at this place? Seems
authors are discussing the problem of teenage pregancies. So, one expects a statement on the
risks of teenage pregnancies - with then, providing the perspective of why women/girls 'choose'
for early marriage.
line 489: "This rate has significantly increased to more than two folds among SR women after
they were displaced to Lebanon"   This statement does not seem to be supported by the data
at all!!