Reviewer ’s report  
 
Title: Differentials in Health -related Quality of Life of Employed and Unemployed Women with 
Normal Vaginal Delivery  
 
Version: 0 Date: 29 Nov 2016  
 
Reviewer: Forough Mortazavi  
 
Reviewer's report:  
 
Comments to authors  
Abstract:  
1. Background should include the necessity of the study besides its objectives.  
2. When was the study conducted? How long did it take? Please mention them in the abstract  
3. Didn't employed women report lower health -related quality of life in 6 and 12 weeks 
postpartum than unemployed mothers? Please explain it in the abstract.  
 
Background:  
4. For line 23 -26, "Persons aged 25 -44 years had better mental health and general health while 
those aged 45 -64 years had better physical functioning and general health", please insert a 
reference.  
5. Please transfer the aims of the study to the last paragraph of the introduction.  
6. In this section, readers need to know the rate of employed women in Nigeria.   
 
Methods:  
7. Maternal depressive symptoms are a confounder. How did you control it?  
8. How many participant were recruited and how many completed the study? Please use a flow 
chart to show it.  
9. In line 4 and 5 of instrument section, there is a mistake in references. Only reference number 
16 is about Iranian SF -36.  
"The Iranian version of the SF -36v2TM was recorded to have a well -documented 
validity1,16,17"  
10. Why didn't you consider parity as an important variable?  
11. Did you check the RM ANOVA assumptions?  
 
Results:  
12. In tables 2 -5, there is a p -value in each row. Please explain what the P -values indicate.  
13. If it is possible, include all demographic variables (age, income, education, parity) in one 
table inst ead of 4 tables. Is it possible to introduce all of them as covariates in one RM 
ANOVA test?  
14. In result section line 49 -51, you mentioned, "Both groups of women had their best HrQoL at 
12 weeks postpartum. Employed women had lower HrQoL at the three ti me-points than the 
unemployed, the poorest being at 18 weeks." How did you conclude that? Is it based on a 
test? Please add the P -value.  
 
Discussion:  
15. There are statements which seem that they could not be supported by RM ANOVA. As far 
as I know, thos e need ANOVA with Tukey test to clarify in which week the HRQoL is best 
and significantly differs from other weeks. Please ask a statistician.   
16. How did you conclude that paid maternity leave of three months should be elongated to six 
months? Your stud y did not cover women at 6th month postpartum.  
Are the methods appropriate and well described?  
If not, please 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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
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 recommend additional statistical review  
 
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 complete a declaration of compe ting 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 relatin g 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 financial 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 declare that I h ave no competing interests  
 
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