Reviewer’ s report
Title: Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women
not attending, irregularly attending and regularly attending childbirth preparation classes
Version: 0Date: 01 Apr 2020
Reviewer's report:
Interesting study, makes a meaningful contribution to the literature. I make a few suggestions for
improvement:
1) In the "Study design and participants" section, it sounds like it's an randomized trial but it isn't
(i.e. women were "assigned" to three groups). Please state that more clearly here. Maybe replacingthis with "women's attendance was used to create three categories, defined as follows…"
2) Why was history of depression and stressful events in the family exclusionary? I imagine this
would be a fairly high percentage of the population, which would introduce unnecessary bias inyour sample. This potential for bias should be acknowledged in the limitations section. Also, howwere these variables assessed?
3) Related to the above point, more details about how many participants were excluded for each
reason would provide a better picture of how generalizable this sample is. Providing a CONSORTparticipant flow diagram would be ideal.
4) In Table 1, the authors make reference to marital satisfaction and spousal support - how were
these assessed? This information should be added to the methods. I find it curious that "Too much"
is an option for marital satisfaction? What does that mean - it would be good to know the question
that was posed.
5) A paragraph in the methods section should be devoted to describing the intervention. How
many participants to a group? How many sessions? Does it follow a set structure? If so, it wouldbe nice to know the topics covered at each class. The more details that can be provided, the morethese results will be clinically meaningful to others who are considering establishing a similarprogram.
6) How do the authors make sense of the fact that irregular attendance was just as effective as
regular attendance? Does this suggest that the full course could be shortened and be just aseffective? This should be discussed in the discussion section.
7) The fact that this is not a randomized trial should be added to the limitation section.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
YesAre 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 furtherassessment in your comments to the editors.
I am able to assess the statisticsQuality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being publishedDeclaration of competing interests
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