PONE-D-20-31636

Interventions to minimize blood loss in very preterm infants – a systematic review and meta-analysis

PLOS ONE

Dear Dr. Bruschettini,

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Olivier Baud, MD, PhD

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors present a well written systematic review and meta-analysis manuscript focusing on the potential influence of blood loss on common prematurity co-morbidities and interventions to prevent blood loss in the infants from birth. This is an important review and one of interest in many neonatologists.

However, I have some minor issues and comments:

Minor issues:

1. Section "Results", page 17, sentence 414-415 : “Three studies were relevant for the comparison blood sampling from the umbilical cord or from the placenta vs. blood sampling from the infant”: The studies using umbilical cord or from the placenta vs. blood sampling from the infant are two and not three. There is an inconsistency here, authors must verify it throughout the article.

2. Section "Results", page 17, sentence 417-418 :, “two studies were relevant for the comparison devices to monitor glucose levels, subcutaneous vs. conventional blood sampling“: The studies using u devices to monitor glucose levels, subcutaneous vs. conventional blood sampling are three and not two. There is an inconsistency here, authors must verify it throughout the article.

Minor comments:

1. Section "Methods": Did the authors think that their search strategy was good enough to cover all the relevant studies? Why pre-specified the specific interventions? They could have missed relevant trials for the systematic review. Add maybe a suggested optimisation for this search strategy in the discussion section

2. Section "Methods": Why did the authors decide to apply no language restrictions to the search strategy? How did they handle the translations without any error or bias?

3. Section "Methods": Why did the authors decide to use the I2 statistic heterogeneity measure and not others, like Q statistic, H2 statistic, R2 statistic, etc.?

4. Section “Discussion”, page 50, sentence 1216: Concerning the figures 7 and 8, it’s not clear in this section to what correspond each figure. Authors must clarify the methods used for these funnel plots. These methods are not presented in the “method” section, including them will improve the consistency of the manuscript.

5. Section “figures”, Funnel plots, fig 7 and 8: Authors should label the difference between the two funnel plots in the figures’ section as they are almost identical.

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Reviewer #1: No

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Interventions to minimize blood loss in very preterm infants – a systematic review and meta-analysis

PONE-D-20-31636R1

Dear Dr. Bruschettini,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Olivier Baud, MD, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I would like to thank the authors for addressing my comments and for all the modifications in the manuscript.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No