Reviewer ’s report  
 
Title: Women born with very low birth weight have similar menstrual cycle pattern, pregnancy 
rates and hormone profiles compared with women born at term  
 
Version: 0 Date: 28 Jan 2019  
 
Reviewer: Nanette Santoro  
 
Reviewer's report:  
 
The authors have attempted to perform a very difficult study and have provided some new and 
useful data despite several shortcomings in the approach which diverge from the ideal.  The 
purpose of the manuscript is to describe reproductive health parameters in 27 -28 year old women 
who were born at very low birth weight.  The sample size is too small to draw firm conclusions, 
but as noted above this is an extraordinarily difficult study to complete and therefore any 
information is welcome about the topic.  Non etheless, there are several clarifications that the 
authors need to provide to allow a reader to interpret the data.  
1. There are two ways to be born at VLBW: either one is born very prematurely or one is 
severely small for gestational age.  It is not cle ar how many of the women who underwent 
hormonal assessment were in each category.  While the sample size is overall small, it would 
be helpful to distinguish these two groups because they may have different reproductive 
parameters.  
 
2. Reproductive hormone s drawn at random throughout the menstrual cycle have very limited 
value for comparison purposes given the very large fluctuations across the menstrual cycle.  
This should be specifically acknowledged as a limitation of interpretation.  AMH levels, not 
he other hand, vary far less across the menstrual cycle and are a more valid measurement.  
 
3. Pages 5 -6, lines 143 -159 are confusing, as are page 8 lines 180 -185.  Line 142: The 25 
women using hormonal contraception are subtracted from the overall 49?  Please  be more 
specific. The 'misunderstanding' alluded to on line 145 is also unclear.  Does this mean that 
the 25 women using hormonal contraception did not have an AMH determination?  If so, 
then please simply say so.  Please specify that menstrual cycle data  was NOT utilized for 
women using hormonal contraception. On lines 180 -185, the numbers do not seem to add up 
correctly.  Please clarify.  If 80 girls were enrolled at both, and 49 participated in follow up, 
the number two completed questionnaires and the number who completed both 
questionnaires and hormone determinations should be explicitly derived. How the numbers 
go from 49 on line 180 to 45 on line 185 seems to be an impossible calculation.  Please 
clarify.  
 
4. If p<0.05 is taken as statistically signi ficant, then the systolic blood pressure differences 
between the two groups bears comment (Table 2).  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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 the manuscript:  
 
Acceptable  
 
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 receiv ed 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 financial competing interests?  
 
6. Do you have any non -financial competing interests i n 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 declare tha t I have no competing interests  
 
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