Reviewer’s report
Title: 
Characterization of Gut Microbiota Associated with Clinical Parameters in
Intrahepatic Cholestasis of Pregnancy
Version: 
1 
Date: 
22 Apr 2020
Reviewer: 
Jian-She Wang
Reviewer's report:
The revised version improved a lot and relieved most of my concerns. Still a few
minor suggestions:
Title: I'd suggest replacing "pregant patients" with "gregnancy".
Abstract: conclusion: it is better describe what kind of changes happened for
ICP.
In the Discussion, please give more detail on the relationship of the "increase of
pathogenic bacteria" and "the progression of ICP" in detail, and describe the
relationship of the "increase of pathogenic bacteria" and "symptoms in ICP
patients"
In the Background, line 147-148, it may be better to list diseases related to
cholestasis with gut microbiota rather than "inflammatory disorders, obesity, and
colon cancer", such as cirrhosis, cholangitis and etc. References: PMID:
23851335; DOI: 10.4161/gmic.25723,PMID: 30872395; DOI: 10.1136/gutjnl-
2018-316670 may help you.
In the Study Participants, line 215-216, please add a time range for the time
without antibiotic treatment.
In the Study Participants, line 217, please describe the selection criteria of the
control group in detail. whether the gestational ages of these two groups are
comparable?
In the Sampling, line 225-226, three indicators (Tbil, Dbil, Ibil) appearing at the
same time is slightly redundant, for Tbil = Dbil + Ibil.
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.
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 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 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 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 have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title: 
Characterization of Gut Microbiota Associated with Clinical Parameters in
Intrahepatic Cholestasis of Pregnancy
Version: 
1 
Date: 
22 Apr 2020
Reviewer: 
Jian-She Wang
Reviewer's report:
The revised version improved a lot and relieved most of my concerns. Still a few
minor suggestions:
Title: I'd suggest replacing "pregant patients" with "gregnancy".
Abstract: conclusion: it is better describe what kind of changes happened for
ICP.
In the Discussion, please give more detail on the relationship of the "increase of
pathogenic bacteria" and "the progression of ICP" in detail, and describe the
relationship of the "increase of pathogenic bacteria" and "symptoms in ICP
patients"
In the Background, line 147-148, it may be better to list diseases related to
cholestasis with gut microbiota rather than "inflammatory disorders, obesity, and
colon cancer", such as cirrhosis, cholangitis and etc. References: PMID:
23851335; DOI: 10.4161/gmic.25723,PMID: 30872395; DOI: 10.1136/gutjnl-
2018-316670 may help you.
In the Study Participants, line 215-216, please add a time range for the time
without antibiotic treatment.
In the Study Participants, line 217, please describe the selection criteria of the
control group in detail. whether the gestational ages of these two groups are
comparable?
In the Sampling, line 225-226, three indicators (Tbil, Dbil, Ibil) appearing at the
same time is slightly redundant, for Tbil = Dbil + Ibil.
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.
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 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 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 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 have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title: 
Characterization of Gut Microbiota Associated with Clinical Parameters in
Intrahepatic Cholestasis of Pregnancy
Version: 
1 
Date: 
22 Apr 2020
Reviewer: 
Jian-She Wang
Reviewer's report:
The revised version improved a lot and relieved most of my concerns. Still a few
minor suggestions:
Title: I'd suggest replacing "pregant patients" with "gregnancy".
Abstract: conclusion: it is better describe what kind of changes happened for
ICP.
In the Discussion, please give more detail on the relationship of the "increase of
pathogenic bacteria" and "the progression of ICP" in detail, and describe the
relationship of the "increase of pathogenic bacteria" and "symptoms in ICP
patients"
In the Background, line 147-148, it may be better to list diseases related to
cholestasis with gut microbiota rather than "inflammatory disorders, obesity, and
colon cancer", such as cirrhosis, cholangitis and etc. References: PMID:
23851335; DOI: 10.4161/gmic.25723,PMID: 30872395; DOI: 10.1136/gutjnl-
2018-316670 may help you.
In the Study Participants, line 215-216, please add a time range for the time
without antibiotic treatment.
In the Study Participants, line 217, please describe the selection criteria of the
control group in detail. whether the gestational ages of these two groups are
comparable?
In the Sampling, line 225-226, three indicators (Tbil, Dbil, Ibil) appearing at the
same time is slightly redundant, for Tbil = Dbil + Ibil.
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.
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 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 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 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 have no competing interests
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal
assistant