PONE-D-24-25872Perceived Paternal Fertility Emotion and Its correlates in Ethiopia among a Cohort of Pregnant Women: Community based Longitudinal SurveyPLOS ONE

Dear Dr. Damtew,

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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

Reviewer #2: Partly

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

Reviewer #1: Yes

Reviewer #2: 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

Reviewer #2: 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

Reviewer #2: No

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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: Title:

- Please include that this is a secondary data analysis and specify the year of the study.

Abstract:

- Results Section: There is an inconsistency regarding higher birth order. The authors report that having 3 to 12 children (AOR=0.14) is associated with higher birth order, yet at the end of the results section, they state that higher birth order was a significant predictor of being happy about the index pregnancy. Please clarify this inconsistency.

Background:

- The introductory paragraph could benefit from restructuring. I recommend following a funnel approach to better organize the background information.

Language and Style:

- The manuscript would benefit from improvements in English language grammar and overall writing style.

Methodology:

- Sample Population: Provide additional details about the PMA (Performance Monitoring for Action) including the sampling process and the type of data collected.

- Study Design: The authors describe this study as a cohort study. However, it is unclear if the pregnant women were followed over time to assess any changes in their partner's emotions towards the pregnancy. Please clarify this aspect.

- Data Collection: The rationale for accessing data at 6 weeks postpartum is unclear. Were participants questioned about their pregnancies post-delivery? The absence of reporting on this second data point suggests that this might be more accurately described as a cross-sectional study, where a group of women was surveyed about their pregnancies at a single point in time.

Sample Size:

- Include a flowchart diagram illustrating the sample selection process and how the final sample size was determined.

Independent Variables:

- Please enumerate the individual-level and enumeration area-level variables used in this study.

Discussion:

- The second paragraph is unnecessary and poorly written.

- Overall, the discussion section is underdeveloped and requires significant improvement.

Reviewer #2: Dear authors,

congratulations on your study. The subject is important and relevant to outlining care for pregnant women and their partners. Some suggestions listed below could strengthen your manuscript.

In the introduction:

1. I was unsure if ‘Intention to conceive’ is the same as ‘Intention to fertility’? You talk about these expressions and they seem to be synonyms, but they can be totally different when you investigate the meaning of the words. If you're referring to different processes, I'd gently suggest making that clearer in the text. A brief adjustment to the paragraph is sufficient.

On the method:

2. I'm understanding that the aim of the study was to determine the level of perceived paternal fertility emotion about the index pregnancy among a cohort of pregnant women and to identify their correlates for such variation, right? But when I read the method, I realise that the data was collected from women. I wonder if I've understood the objective correctly, because how can we measure the perception of fathers through mothers? Shouldn't this information be collected from men?

3. What was the design of the study presented in this article? Was it a cross-sectional study with qualitative data? or quantitative? or mixed method? I strongly suggest signalling this right at the beginning of the method passage.

4. Although the data has already been published, providing a brief contextualisation of the study makes it easier to understand. I'm not saying that you have to write everything down in exhaustive detail. Just contextualise it simply and objectively: this is a cross-sectional study of the baseline of a prospective cohort. The data was collected from pregnant women in X health centres in Ethiopia....

5. Where you reference the details of the Ethiopia PMA, I suggest that you leave only the citation of the study and move the reference to the references section. For example: ‘A detailed description of the Ethiopia PMA protocol has been published previously (citation)’ or ‘Information regarding the selection of the sample and the units is described in detail in the Ethiopia PMA protocol (citation)’.

6. I kindly suggest that you objectively describe which sample was used in this article. It doesn't matter if you recruited people with a different profile at other points in the study. What matters is that you make it clear what the inclusion and sampling criteria were for the section of the study you are presenting here. For example: puerperal women were recruited throughout the study, but only pregnant women were recruited at baseline. So you can go straight to the information that the sample consists of pregnant women.

Results:

The findings are very good. The quality of the data is excellent, given the size of the sample and the categories of responses. It's positively surprising!

7. It would be very comfortable for the reader if you could include the number of participants who were included in the analysis in the second line of the results. Even if it is already well described in the method, just for comfort in reading and interpreting. ‘2115 women took part in the study. The proportion of parental emotion....’ is enough.

8. In the passage: Correlates of Perceived Paternal Fertility Emotion about the Index Pregnancy among a panel of pregnant women and its correlates in Ethiopia, Evidence from Cohort One Baseline Data, 2019 to 20. The first sentence “This study investigated factors affecting perceived paternal fertility emotion about the index pregnancy among a cohort of pregnant when their husband and/or partner learned their wife´s index pregnancy” fits better at the end of the introduction or in an objective passage. You don’t have to rewrite it in the results because it should be clear in the method. So I truly suggest you exclude this sentence in this paragraph, but consider bringing it to the end of the introduction or at the beginning of the method.

Discussion:

9. In the second paragraph of the discussion you cited “the authors” two times. It is not clear if you are talking about the authors of the dataset or if you are talking about you (authors of the manuscript) in a third voice. If you are talking about the dataset’s authors, I strongly suggest you provide the citation in this paragraph. If you are not, I suggest making it clear that you are discussing your findings. This passage is a little confusing.

10. What limitations did the study have? Think about reiterating that paternal feelings were assessed through women's reports and are therefore subject to bias. How can someone else tell what I'm feeling?

Conclusion:

11. I totally agree with your point of view, but you should respond to your study’s objective here. The other statements about what to do with these findings must be discussed in the discussion passage.

12. the English is a little hard to follow. An English language review would be nice.

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Reviewer #1: Yes:  Nebyu Amaha

Reviewer #2: No

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PONE-D-24-25872R1Perceived Paternal Fertility Emotion and Its correlates in Ethiopia among a Cohort of Pregnant Women: Community based Longitudinal Survey; A Secondary Data Analysis of 2019/20 Baseline SurveyPLOS ONE

Dear Dr. Damtew,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Jan 16 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols .

We look forward to receiving your revised manuscript.

Kind regards,

Yibeltal Alemu Bekele, MpH

Academic Editor

PLOS ONE

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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: Partly

**********

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: No

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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: Abstract

1. The term "fertility emotion" should be defined briefly to ensure clarity for readers unfamiliar with the concept.

2. Clarify how the findings contribute to existing knowledge or practice.

Introduction

1. Clearly articulate the specific research gap this study addresses. While it is implied that limited research exists in this area, explicit evidence (e.g., citing prior studies or lack thereof) would strengthen the justification.

2. The research objectives should be stated more explicitly. For example:

"This study aims to explore the perceived fertility emotions of male partners and examine their correlates among pregnant women in Ethiopia."

3. Clearly define how "Paternal Fertility Emotion" concept was operationalized. Were validated tools used, or was a new tool developed? If a new tool was developed, describe the validation process.

Results

1. Ensure consistency in terminology. For instance, if terms like "positive fertility emotion" or "negative fertility emotion" are used, define them clearly and use them consistently throughout the manuscript.

Discussion

1. Clearly explain how this study addresses the identified gap in knowledge.

2. Discuss the implications of these findings for maternal and paternal health policies or interventions in Ethiopia not a copy-paste of an implication from another study!! “The implication of this study is increasing men fertility knowledge and their emotional readiness as supported by a finding from a study Men with university education had better fertility knowledge than men without university education along with lifestyle adjustment before pregnancy to improve health and fertility (32)”

3. The limitations section should be expanded to address potential biases (e.g., social desirability bias in responses) and generalizability concerns.

4. Suggest specific areas for future research, such as exploring fertility emotions across different cultural or socio-economic groups.

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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: Yes:  Nebyu Daniel Amaha

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step.

Perceived Paternal Emotional Fertility Intention and Its correlates in Ethiopia among a Cohort of Pregnant Women: Community based Longitudinal Survey; A Secondary Data Analysis of 2019/20 Baseline Survey

PONE-D-24-25872R2

Dear Dr. Solomon Abrha Damtew,

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Academic Editor

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