Reviewer's report
Title:Effect of the mode of delivery on Crohn's disease; results from a
retrospective cohort study
Version: 1Date:2 June 2010
Reviewer: Olof Stephansson
Reviewer's report:
Thank you for the opportunity to review the manuscript. This is a retrospective
study on 114 women with Crohn’s disease investigating whether mode of
delivery and episiotomy influence disease progression after pregnancy.
In general this is a well conducted study, the statistical methods and
interpretation of data is appropriate. The main concern is the limited size of the
study and whether the data reflects recent clinical practice. Furthermore are the
results due to differences in year of delivery between the groups of women with
Crohn’s disease?
Major Compulsory Revisions
1. The median interval between questionnaire and delivery was 10 years with a
range between 1-39 years. This means that the clinical practice for both Crohn’s
disease and obstetrics have changed during the study period. Could this
influence the findings? Have the authors performed any analyses on the most
recent part of the dataset? Did year of delivery differ between the groups
studied?
2. What was the median time from diagnosis of Crohn’s disease and delivery of
the index child? Did disease duration influence the findings?
3. Some women may have become pregnant during follow up. Did this alter the
results? Could this introduce bias?
Minor Essential Revisions
1. OR in tables 2-4 should be omitted and presented in the results section results
only.
2. There is no information on analysis for OR calculations in the Methods section.
P6 Statistical analysis.
3. Could the authors expand on how episiotomy could prevent perianal disease
in the Discussion, P12, L17
4. Last sentences of conclusion, P14 is rather strong given the retrospective
study design.
5. Could the authors please further discuss recall bias and confounding by
indication and how this would influence the findings?
6. How was intrauterine growth restriction and pregnancy induced hypertension
(P5, L7) defined?
7. Could the lower birth weight among women with active disease be attributed to
the difference in distribution of gestational age – 39 vs. 40 weeks of gestation?
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Effect of the mode of delivery on Crohn's disease; results from a
retrospective cohort study
Version: 1Date:2 June 2010
Reviewer: Olof Stephansson
Reviewer's report:
Thank you for the opportunity to review the manuscript. This is a retrospective
study on 114 women with Crohn’s disease investigating whether mode of
delivery and episiotomy influence disease progression after pregnancy.
In general this is a well conducted study, the statistical methods and
interpretation of data is appropriate. The main concern is the limited size of the
study and whether the data reflects recent clinical practice. Furthermore are the
results due to differences in year of delivery between the groups of women with
Crohn’s disease?
Major Compulsory Revisions
1. The median interval between questionnaire and delivery was 10 years with a
range between 1-39 years. This means that the clinical practice for both Crohn’s
disease and obstetrics have changed during the study period. Could this
influence the findings? Have the authors performed any analyses on the most
recent part of the dataset? Did year of delivery differ between the groups
studied?
2. What was the median time from diagnosis of Crohn’s disease and delivery of
the index child? Did disease duration influence the findings?
3. Some women may have become pregnant during follow up. Did this alter the
results? Could this introduce bias?
Minor Essential Revisions
1. OR in tables 2-4 should be omitted and presented in the results section results
only.
2. There is no information on analysis for OR calculations in the Methods section.
P6 Statistical analysis.
3. Could the authors expand on how episiotomy could prevent perianal disease
in the Discussion, P12, L17
4. Last sentences of conclusion, P14 is rather strong given the retrospective
study design.
5. Could the authors please further discuss recall bias and confounding by
indication and how this would influence the findings?
6. How was intrauterine growth restriction and pregnancy induced hypertension
(P5, L7) defined?
7. Could the lower birth weight among women with active disease be attributed to
the difference in distribution of gestational age – 39 vs. 40 weeks of gestation?
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Effect of the mode of delivery on Crohn's disease; results from a
retrospective cohort study
Version: 1Date:2 June 2010
Reviewer: Olof Stephansson
Reviewer's report:
Thank you for the opportunity to review the manuscript. This is a retrospective
study on 114 women with Crohn’s disease investigating whether mode of
delivery and episiotomy influence disease progression after pregnancy.
In general this is a well conducted study, the statistical methods and
interpretation of data is appropriate. The main concern is the limited size of the
study and whether the data reflects recent clinical practice. Furthermore are the
results due to differences in year of delivery between the groups of women with
Crohn’s disease?
Major Compulsory Revisions
1. The median interval between questionnaire and delivery was 10 years with a
range between 1-39 years. This means that the clinical practice for both Crohn’s
disease and obstetrics have changed during the study period. Could this
influence the findings? Have the authors performed any analyses on the most
recent part of the dataset? Did year of delivery differ between the groups
studied?
2. What was the median time from diagnosis of Crohn’s disease and delivery of
the index child? Did disease duration influence the findings?
3. Some women may have become pregnant during follow up. Did this alter the
results? Could this introduce bias?
Minor Essential Revisions
1. OR in tables 2-4 should be omitted and presented in the results section results
only.
2. There is no information on analysis for OR calculations in the Methods section.
P6 Statistical analysis.
3. Could the authors expand on how episiotomy could prevent perianal disease
in the Discussion, P12, L17
4. Last sentences of conclusion, P14 is rather strong given the retrospective
study design.
5. Could the authors please further discuss recall bias and confounding by
indication and how this would influence the findings?
6. How was intrauterine growth restriction and pregnancy induced hypertension
(P5, L7) defined?
7. Could the lower birth weight among women with active disease be attributed to
the difference in distribution of gestational age – 39 vs. 40 weeks of gestation?
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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