Reviewer ’s report  
 
Title: The mode of delivery affects the diversity and colonization pattern of the gut microbiota 
during the first year of infants' life: A Systematic Review  
 
Version: 0 Date: 13 Mar 2016 
 
Reviewer:  vivian  huang  
 
Reviewer’s report:  
 
The impact of mode of delivery on the infant's gut microbiome is very important, as evidence to 
date suggests that the early life gut microbiome is associated with future life risks of immune 
disease s (eg asthma, atopy, obesity). The question the authors attempt to answer with the 
systematic review is to compile evidence of the effect of delivery mode on the diversity and 
colonization pattern of the infant's gut microbiota.  The authors menti on confounding factors 
(feeding, antibiotic use etc) in the methods, and discuss in the discussion, but do not elaborate in 
the results (which would help the reader  in interpreting the results). Perhaps another column in 
your table regarding the included studies - on the numbers of infants by feeding as well as 
delivery method, may help.  
 
Please explain more the inclusion/exclusion for your included articles, as I was wondering why 
Azad et al CMAJ 2013 - Gut microbiota of healthy Canadian infants: profiles  by mode of 
delivery and infant diet at 4 months. was not included based on their inclusion/exclusion criteria.  
 
Are the methods appropriate and well described?  
If not, plea se 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.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the dat a 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.  
 
Not relevant to this manuscript  
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 c ontent of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation 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 a ny 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 interest s. 
 
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 b e 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: The mode of delivery affects the diversity and colonization pattern of the gut microbiota 
during the first year of infants' life: A Systematic Review  
 
Version: 0 Date: 13 Mar 2016 
 
Reviewer:  vivian  huang  
 
Reviewer’s report:  
 
The impact of mode of delivery on the infant's gut microbiome is very important, as evidence to 
date suggests that the early life gut microbiome is associated with future life risks of immune 
disease s (eg asthma, atopy, obesity). The question the authors attempt to answer with the 
systematic review is to compile evidence of the effect of delivery mode on the diversity and 
colonization pattern of the infant's gut microbiota.  The authors menti on confounding factors 
(feeding, antibiotic use etc) in the methods, and discuss in the discussion, but do not elaborate in 
the results (which would help the reader  in interpreting the results). Perhaps another column in 
your table regarding the included studies - on the numbers of infants by feeding as well as 
delivery method, may help.  
 
Please explain more the inclusion/exclusion for your included articles, as I was wondering why 
Azad et al CMAJ 2013 - Gut microbiota of healthy Canadian infants: profiles  by mode of 
delivery and infant diet at 4 months. was not included based on their inclusion/exclusion criteria.  
 
Are the methods appropriate and well described?  
If not, plea se 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.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the dat a 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.  
 
Not relevant to this manuscript  
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 c ontent of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation 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 a ny 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 interest s. 
 
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 b e 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: The mode of delivery affects the diversity and colonization pattern of the gut microbiota 
during the first year of infants' life: A Systematic Review  
 
Version: 0 Date: 13 Mar 2016 
 
Reviewer:  vivian  huang  
 
Reviewer’s report:  
 
The impact of mode of delivery on the infant's gut microbiome is very important, as evidence to 
date suggests that the early life gut microbiome is associated with future life risks of immune 
disease s (eg asthma, atopy, obesity). The question the authors attempt to answer with the 
systematic review is to compile evidence of the effect of delivery mode on the diversity and 
colonization pattern of the infant's gut microbiota.  The authors menti on confounding factors 
(feeding, antibiotic use etc) in the methods, and discuss in the discussion, but do not elaborate in 
the results (which would help the reader  in interpreting the results). Perhaps another column in 
your table regarding the included studies - on the numbers of infants by feeding as well as 
delivery method, may help.  
 
Please explain more the inclusion/exclusion for your included articles, as I was wondering why 
Azad et al CMAJ 2013 - Gut microbiota of healthy Canadian infants: profiles  by mode of 
delivery and infant diet at 4 months. was not included based on their inclusion/exclusion criteria.  
 
Are the methods appropriate and well described?  
If not, plea se 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.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the dat a 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.  
 
Not relevant to this manuscript  
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 c ontent of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation 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 a ny 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 interest s. 
 
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 b e 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