Title: The association of maternal anaemia with adverse maternal and foetal outcomes in Somali
women: a prospective study
Version: 1 Date: 11 Mar 2023
Reviewer:  Jama Ali Egal
Reviewer's report:
Title: The association of maternal anaemia with adverse maternal and foetal outcomes in Somali
women: a prospective study
Thank you for this Manuscript. This was a very interesting study that can have huge benefits
when published for data availability in the Somali region. The issue of Anaemia in Pregnancy
and delivery has implications for Somali women and their newborns, yet it is under reported
and does not receive the appropriate attention from health leaders and policy makers. I have
provided some of the most important comments in a table format below. Thank you.
Abstract
• In the background of the abstract, you mention the first part of the Aim is to identify last
trimester anaemia in pregnancy. This is not in the results.
• In the methods section of the abstract, there should be no results presented.
Background
• Here accurate rationale for the study is missing.
• The Aim is different to the Aim in the Abstract.
• Many studies in Somali Ethiopian Region are missing.
• Sentences need restructuring and language check.
• Missing the local context section, available numbers, antenatal/ postnatal care in Somalia,
Homebirth rate, Maternal mortality rates in Somalia etc.
Methods
• The method of data collection was identified as prospective, which is best suited for the context
of Somalia, yet you mention data were retrieved from hospital records.
• Please explain how missing data issue was solved for accuracy of results.
• Who collected the data?
• Were the staff provided any training during the data collection?
• In case of no early ultrasound: the Manuscript mentions that one was provided with physical
examination to all women, when and by whom was this done? How many women were these
within the included cases?
• Inclusion criteria: only women with documented placental disease? Why?
• Exclusion criteria: Numbers of cases excluded.
Results
• Missing data of comparison of antenatal Hb levels and Hb at birth levels.
• The tables need to be presented differently. To give better view of the data using separate
columns.
Discussion
• Limitations should be best discussed after the discussion.
• In the discussion it is reported that there is no similar study done in SSA, yet report on
systematic reviews and many studies in SSA countries on your topic.
• In discussion is a repetition of the results.
• Reporting of other study results without discussion and comparing to own results and the
interpretations.
• Missing suggestions and real discussion of the findings.
• What are the clinical implications of this study, what do you suggest should be done about
the issues you mention.?
Conclusion
Revise Conclusion as per advice in Discussion section.
Ethical considerations
• Missing the ethical approval from the Ministry of Health. If not sought, then should have sough
patient consent to use their data.
• If Hb was only taken only for the purpose of this study, this has ethical considerations for
this study and subjecting women through intervention for data and publications which should
be further discussed.
References  • Update Please.