https://orcid.org/0009-0002-0405-8915
Peer Review History
| Original SubmissionJanuary 5, 2025 |
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Association between depression during pregnancy and preterm birth: results from population cohorts and mouse experimental models PLOS ONE Dear Dr. Chen, 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 Aug 23 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:
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Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and 2. To comply with PLOS ONE submissions requirements, in your Methods section, please provide additional information regarding the experiments involving animals and ensure you have included details on (1) methods of sacrifice, (2) methods of anesthesia and/or analgesia, and (3) efforts to alleviate suffering. 3. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section. 4. Thank you for stating the following financial disclosure: This project is supported in part by a Kunming Medical University grant. 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If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? Reviewer #1: Yes Reviewer #2: Yes ********** 2. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: Yes Reviewer #2: Yes ********** 3. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: Yes Reviewer #2: Yes ********** 4. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes Reviewer #2: No ********** Reviewer #1: The manuscript addresses an essential issue of examining the association between prenatal depression and preterm birth. The study's design to examine this phenomenon is very valuable: a dual approach combining a prospective human cohort with experimental animal modeling. This integrated perspective is relatively novel and adds valuable evidence to the field. I recommend accepting the manuscript with minor revisions. Here are some comments referring to its sections: The conclusion sentence in the Abstract section implies causality ("Our study provides evidence that depression during pregnancy is a significant risk factor for PTB") without qualification. Since the human study is observational, please revise the statement to emphasize association rather than causation, unless referring specifically to the animal experiment. The Introduction section provides a thorough background on the prevalence and significance of depression during pregnancy and its potential link to PTB. The Methods section is detailed and generally well-described. Please elaborate on how the EPDS cut-off of 12 was chosen and whether it has been validated in the Chinese population or within a similar cultural context. The findings in the Results section are well-structured, with clear subgroup and multivariate analyses. I suggest considering separating mouse results and human results more distinctly for readability. The Discussion section tends to focus predominantly on technical explanations and statistical/methodological interpretations. This section would benefit from deeper conceptual engagement with the findings, particularly in terms of theoretical implications, public health relevance, and the broader psychosocial context of maternal depression. The current narrative in the Discussion section lacks sufficient interpretive depth; the authors are encouraged to reflect more critically on why these associations might exist. Please moderate claims of causality in the Discussion section when referring to human cohort findings. The Discussion section would benefit from a more explicit acknowledgment of the limitations of the current study. Typos: • Page 6, last paragraph: "…and the effect is significant ." – The period should be attached to the word (there is an unnecessary space). • Page 7, second paragraph: "…to the surface of the water ." – The period should be attached to the word (there is an unnecessary space). • Page 10, first paragraph: "with RR values of 2.54 (1.38-4.67, P=0.003)" – A space should be added before and after the '=' sign. • Page 12, second paragraph: "between the two groups(sTable 4)." – A space should be added after the word and before the parentheses. Reviewer #2: 1. Abstract 1.1 The abstract introduction should clearly define the main variables of interest, such as 'depression' and 'preterm birth.' Providing standard definitions helps ensure clarity and consistency for the reader. 1.2. The manuscript lacks detailed information about the cohort study's design. Please specify the sample size, sampling, analysis, inclusion and exclusion criteria, recruitment process, diagnostic tools used for assessing depression. 2. Introduction 2.1. Define operational criteria for classifying participants as depressed vs. non-depressed 2.2. Mention area of study, year of study, RR, study design for each specific studies mentioned on the introduction i.e The results of a recent review suggest that….. 2.3. Please revise for clarity and correct potential typographical errors i.e The degree of association between PTB and PTB varied between….. 3. Methodology and Materials 3.1. Include standard and operational definitions i.e depression/ non depression 3.2. Depression Validation in Mice: While behavioral tests are described, you do not report actual outcomes or statistical thresholds confirming that stress induced depression. Clarify how model success was verified, referencing standard cutoffs or literature benchmarks 3.3. Confounder Adjustments in Cohort: The statistical methods mention t-tests and chi-squared tests, but do not detail whether multivariate analyses adjusted for known confounders (e.g., maternal age, BMI, socioeconomic status). 3.4. Sample Size and Power Calculations: The rationale for choosing 320 depressed and 1146 non-depressed women, or 80 vs. 20 mice, is not provided. Including a priori power estimates would bolster rigor. 3.5. Animal Model Justification: While the use of the CUMS model is appropriate, more information is needed about the specific stressors applied, duration of exposure, and how depression was validated in mice. Additionally, clarify the criteria used to define PTB in the animal model. 3.6. Inclusion and exclusion: the reason for inclusion or exclusion of specific groups needs to be described. 3.7. Animal Welfare and ARRIVE Compliance: You describe the stressors and housing conditions, but lack an explicit statement about compliance with the ARRIVE guidelines or specific institutional animal welfare protocols. 3.8. Ethical review and informed consent: Animal Study: State whether the animal experiments were approved by an institutional animal care and use committee and conducted in accordance with relevant guidelines. 3.9. Sample Size Justification: Provide a rationale for the sample sizes in both the human and animal studies, including any power calculations performed to ensure the studies were adequately powered to detect meaningful differences 4. Result 4.1. Clarify non-significant findings: The text should better contextualize why some sociodemographic variables showed no significant associations. 5. Minor Comments 5.1. Abbreviations: Define all abbreviations at first use and ensure consistent usage throughout the manuscript. i.e Abstract CUMS 5.2. List of abbreviation to be ordered in alphabet and should be written in a uniform manner i.e Capital/Small letter 5.3. Reporting style: Some figures and tables (e.g., sTable 1, sFigure 1,) fig/figure are mentioned but not clearly summarized in the narrative—briefly describing key values would improve readability. 5.4. Not advised to start a paragraph with abbreviation 5.5. Figures and Tables: Ensure that all figures and tables are clearly labelled, include descriptive legends, and are referenced appropriately in the text. ********** 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: Keren Michael Reviewer #2: Yes: Kidest Getu Melese ********** [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. 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| Revision 1 |
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Dear Dr. Chen, 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. ============================== Editor:I have provided my comments below. ============================== Please submit your revised manuscript by Dec 17 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.
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, Samson Nivins, Ph.D Academic Editor PLOS ONE Journal Requirements: If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. Additional Editor Comments: Thank you for making the changes. I have lots of suggestions for the authors to consider before accepting for publications. Given my expertise in prenatal exposures particularly in the context of human studies I have given my feedback. Major concern: Why was pre-pregnancy BMI and parity not controlled for The study was conducted during COVID 19 global pandemic, so how well authors can say its because of antenatal dep, not bec of COVID 19 anxiety and depression. Abstract: Can you briefly add a background and then redirect to your study aims. Add risk of preterm birth Remove the bold from aims. Add in methods of abstract, add depression symptoms, as EPDS is not a diagnostic tool rather it’s a screening tool. Rewrite the results in the abstract properly and define RR. Do refer how others write results. Don’t add RR and values in conclusion Revise the conclusion currently you’re just writing the results again. Add few lines of overall results and provide a suggestion and point to the future direction. General comments: Don’t state literature…in your text. Use previous studies Introduction What is meant by today? In the introduction add 2025 if it’s so. Along with months. I quickly checked the reference, but the reference is until 2021? In the second para, spell what are the multiple risk factor? In the same para you have described how it’s going to affect, add 1-2 lines as it’s the major objective of the study. I am not clear by these statements what authors want to say. “The strength of association between prenatal depression and PTB varied between ethnic groups, and the association between depression during pregnancy appears to be stronger in Asians Yunnan [25-27], as a multiethnic region, has not reported the association between depression during pregnancy and PTB, and it remains to be determined whether the effect of depression on PTB is different from that found in other regions” Add rationale why do you think it varies with different ethnic origin. The major missing is what is the rationale behind the use of animal models, add a paragraph explaining previous studies on animals’ models, what they found with respect to PTB and also report studies looking at antenatal depression on fetal brain development. Add details of what is need for looking at a population from Yunnan. How does it vary from other Chinese province. If you had any prior hypothesis add that too. Methods: I think you need to keep it as women with depressive symptoms, don’t just keep it as depressive alone it confuses. Given the lack of my expertise in animal models I am not comments on animal model part, I have seen reviewers with that expertise have commented. Statistical analysis: Can you add the assumption of Cox Proportion model. Why was BMI, parity, marital status not considered? I would strongly suggest adding those in the model. For e.g., marital status I can see it in the Table 1. But still it play a major role. I would suggest three models. 1. Crude model 2. Current model 3. Current model + BMI + Parity Importantly, I am concerned that the recruitment happened during COVID 19 pandemic, how authors adjust control for it. See papers how they accounted for. https://www.nature.com/articles/s41390-024-03620-7 https://www.sciencedirect.com/science/article/pii/S2949732924000735 Further in the screening tools for depression during pregnancy – when was the questionnaire administered. I can’t find any details of it. How many responded and did not. Add those in Fig 1. Revise as depressive symptoms don’t keep it as diagnosis Results: “Notably, the incidence of depression in rural pregnant women was slightly higher than that in urban pregnant women, with depression incidence rates of 26.01% and 18.77%, respectively” Don’t compare it in results, just talk about your results, rest all move to discussion. Same way remove this too “which may reflect the narrow age range of the cohort and the limited variability of testing, as well as the homogeneous cultural practices of prenatal care among ethnic groups in Yunnan” In the results section just describe your results. Add crude and Model 2 results in your revision. I can’t find what is the rationale for conduction degree of depressive symptoms. If you want to have those results, add it as aim in the introduction and add it as statistics too. I can see any bivariate analysis in the statistics…..Pls add. Also do multiple comparison corrections given the number of tests., I am unclear why authors did this tests (Subgroup analysis of depression and PTB during pregnancy) from where they have got the information for section trimester… Don’t add any new tests – if its post hoc specify it as posthoc. And I can’t find details of when was demographics questionnaire administered. Plus what is meant by “those in the second trimester (RR, 2.60; 95% CI, 1.18-5.70), with… Overall, the results section needs clarity and rewrite the whole results sections. All the tests need to specify earlier in statistics and should be in the same order. Don’t do any fishing of tests. I can’t find discussion subheading? Pls include. What do you mean by preventive role “To our knowledge, this is the first report to explore the preventive role of depression during pregnancy on PTB in both human and animal studies” In the discussion authors state that “Characteristics of the impact of depression on PTB in Yunnan. The detection rate of depression during pregnancy is higher than that reported in previous studies” Can this be due to COVID? I can’t find detailed discussion about PTB among mothers with depression. Add strengths [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #3: (No Response) Reviewer #4: All comments have been addressed Reviewer #5: (No Response) Reviewer #6: All comments have been addressed Reviewer #7: (No Response) ********** 2. Is the manuscript technically sound, and do the data support the conclusions??> Reviewer #3: Yes Reviewer #4: Yes Reviewer #5: Yes Reviewer #6: Yes Reviewer #7: Partly ********** 3. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #3: Yes Reviewer #4: Yes Reviewer #5: Yes Reviewer #6: Yes Reviewer #7: Yes ********** 4. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #3: Yes Reviewer #4: Yes Reviewer #5: Yes Reviewer #6: Yes Reviewer #7: Yes ********** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #3: No Reviewer #4: Yes Reviewer #5: Yes Reviewer #6: (No Response) Reviewer #7: No ********** Reviewer #3: Comment Author contribution section Comment 1: In the author contribution section, you have described that authors have different contributions falling in two categories and it is better to describe the contribution of each author in words rather than simply describing as have equal contribution. Comment 2: Better to use a special character in the author list to indicate the corresponding author and no need of repeating the affiliation describing in author information to indicate corresponding author. Comment 3: Please remove or provide a reason for using “hyphen” for words in funding section. Comment 4: Please include full terms for the acronyms/abbreviation such as “ARRIVE’ and “NIH” (ethical consideration section) in your abbreviation section. Abstract section Background section: No need of writing sentences in bold and use period(.)after the word scarce. Method section: Please provide information about sample size, sampling procedure, study design and sampling procedure and how you reach your samples. It is not recommended to write about the definition of what PTB mean in this section. There is also spacing error (line 4). Please revise it and made necessary correction. Introduction section The introduction section needs minor revision regarding word utilization such as (for example better to use “Low- and middle-income countries” instead of low-income and middle-income countries), and it also for spacing and punctuation marks utilization. Material and Methods section Comment 1: Better to write the Ethical review and informed consent part of your manuscript at the end of methods and material section. Comment 2: As the methods section is the core of the study, your research project lacks clarity. In the methods section, the study design, sampling, sampling procedure, Data quality management, Source and study Population, operational definitions should be described in clear and concise way to make clear for the reader. Your research project needs revision regarding these issues. You have to write the details how you recruited 1466 participants from 1500 and your study flow chart (figure 1) is not also matched with this sample size. Please check it for more clarity. Comment 3: Please try to separate sub-headings from the rest of the paragraph following it. It is recommended to use either separate line or using colon. Comment 4: For what SPF is standing for? Please include it in your abbreviation section. Comment 5: Better to avoid words like PTB during pregnancy, simply if you mention PTB, it is known that it happens during pregnancy. So, no need of writing like “PTB during pregnancy”. Comment 6: Please provide the operational definitions for term Chronic Unpredictable Mild Stress (CUMS) Result and Discussion section Comment 1: Please describe in what unit the household monthly income is measured. Is it in $ US or other? Usually, it is recommended to describe it in US dollars. Comment 2: Please check the font size for headings and-sub headings. Usually, the font size for headings is larger than or equal with subheadings please check for that. Comment 4: please Insert Tables using caption and check spacing and punctuation marks as well. Comment 5: Is depression a risk factor or preventive factor for PTB? Please provide details about this sentence in your result “To our knowledge, this is the first report to explore the preventive role of depression during pregnancy on PTB in both human and animal studies. “Contradicts with conclusion of your study otherwise please briefly explain it. Comment 6: Your discussion part includes unnecessary details, please focus to elaborate more issues related to your study result. Comment 7: What are the Strengths and limitation of your study? General comment, The whole manuscript needs minor revision to make the manuscript is in line with PLOSE ONE guideline and to make concise and clear for the readers. Reviewer #4: Thank you for the opportunity to review this article. It was an interesting and insightful read. here are the few comments, 1. Scope and Inclusion Criteria • While the focus on quantitative studies is clear, excluding qualitative and mixed-methods research may limit the richness of the evidence base. Qualitative studies often provide valuable insights into paternal mental health experiences that may not be captured through quantitative measures. At minimum, the rationale for excluding qualitative studies should be clearly articulated. • Excluding studies where paternal outcomes are embedded within broader "parental" research may unintentionally omit valuable data. Consider allowing inclusion of such studies if fathers’ data are separately reported, even if paternal mental health is not the main focus. 2.Methodological Details • The planned use of JBI critical appraisal tools is appropriate. However, a brief justification for selecting JBI over other tools (e.g., CASP for qualitative studies, if those were to be included) would increase transparency. • The criteria for conducting a meta-analysis (based on I² thresholds) are clearly stated. However, the protocol would benefit from outlining potential subgroup analyses (e.g., by region, type of mental health outcome, or study design) to allow for a more nuanced synthesis if sufficient data are available. • Given the psychological nature of the outcomes, more explanation of why qualitative evidence is excluded would help readers understand the methodological boundaries of this review. • There are minor typographical and formatting inconsistencies (e.g., spacing, repeated phrases), which should be corrected for clarity. 3.Discussion Depth The revised discussion now includes sociocultural context, public health implications, and policy relevance. The addition of population-attributable fraction (PAF=18.7%) is particularly impactful. Further elaboration on potential mechanisms (e.g., HPA axis dysregulation, inflammation) could enrich the theoretical framing. Reviewer #5: 1. Regarding statistical analysis ,though in answer to reviewer comments authors have mentioned how the sample size was calculated ,it is not present in the methodology section of main manuscript. 2. Regarding data availability 4 file have been provided was supporting documents, However in the manuscript it is written that "The data that support the findings of this study are available from the corresponding author upon reasonable request." please clarify. If all data is present in the supporting files mention All relevant data are within the Supporting Information files If all data is not available in the supporting files write which files are available from the which database (accession number(s) XXX, XXX.). 3.Regarding funding source following information is missing, Grant numbers awarded to each author and URL of funder website 4. In the competing interest statement please include the following statement "This does not alter our adherence to PLOS ONE policies on sharing data and materials.” 5. Reviewer 1 has pointed out to add authors Mengmei Liu, Ping Chen, Qingyan Ma, Min Li. This has been agreed by authors but in the manuscript their names are still not present 6. Rest all reviewer comments have been nicely addressed by authors Reviewer #6: I commend the authors for their comprehensive revision of the manuscript. They have been highly responsive to the initial comments from the reviewers and the editor, making significant improvements to the clarity, methodology description, and overall rigor of the work. The combination of a prospective human cohort with an experimental animal model remains a major strength of this study, providing valuable translational insights into the link between prenatal depression and preterm birth (PTB). The authors have adequately addressed most of the previous concerns. However, a few critical points require further clarification and minor revisions before the manuscript can be considered for publication. The authors have provided quantitative thresholds for validating the CUMS model (e.g., ≥30% decrease in sucrose preference). However, it remains unclear how these criteria were applied at the individual animal level. Were all mice in the CUMS group included in the final pregnancy/PTB analysis regardless of their individual behavioral performance, or were only "responders" that met these specific criteria included? This lack of clarity is a significant concern for the model's validity. The methods and results should explicitly state the flow of animals from the initial CUMS group (n=80) to the final analyzed group (n=60 for behavior, n=32 for pregnancy), clarifying the rationale for any exclusions. Causality Language in the Discussion: While the abstract conclusion has been appropriately tempered, the Discussion section still occasionally uses language that implies causality from the human data (e.g., "depression may contribute to," "depression may reduce"). Given the observational nature of the cohort study, the language must consistently reflect an association. The discussion should be carefully revised to frame the human findings as demonstrating a strong and significant association, with the animal model providing supportive, hypothesis-generating evidence for potential causal mechanisms. Interpretation of the Severe Depression Finding: The non-significant association between severe depression (EPDS ≥19) and PTB is a counterintuitive finding that warrants a more thorough discussion. The very wide confidence intervals (1.67, 0.38-7.36) strongly suggest that this result is likely due to a lack of statistical power from a small sample size in this subgroup. This point should be explicitly stated and discussed as a study limitation, rather than leaving the reader to speculate. Sample Size Inconsistency: In Figure 1, the final number for the non-depressed group is listed as 1146. However, based on the numbers provided (1155 initially minus 14 lost to follow-up), it should be 1141. This minor numerical discrepancy should be checked and corrected for accuracy. Discussion Length and Focus: The Discussion is comprehensive but could be slightly condensed and made more concise in places to enhance impact and avoid repetition. Reviewer #7: General Evaluation: The manuscript presents an innovative and valuable research project addressing depression, encompassing both animal models and a group of women affected by depression during pregnancy. The study is generally well-designed, scientifically relevant, and methodologically sound. Experiments conducted on mice appear to adhere to ethical standards and accepted methodological practices. The findings have the potential to make a meaningful contribution to understanding the mechanisms of depression and its effects in different contexts. Major Revisions Suggested: 1. Language and Terminology: The manuscript contains several grammatical and lexical errors that may hinder clarity. Improving language clarity will enhance both readability and credibility. Certain terms need to be revised for scientific accuracy. For example, the use of “normal mice” to describe the control group is not recommended, as it can be interpreted in a vague or colloquial manner. More appropriate terminology includes “control mice” or “non-depressed mice,” which are standard in scientific literature and precisely describe the group’s characteristics. In the previous version of the manuscript, the following sentence appeared in the Results section: “Subgroup analysis revealed that pregnant women aged 25–34 years in the second trimester with lower annual family income, higher education, living in urban areas, having no occupation, and a married spouse were at higher risk for PTB due to depression during pregnancy.” Upon review, several linguistic and stylistic issues were identified that could affect clarity and precision: Lack of parallel structure: The attributes in the list (e.g., with lower income, higher education, living in urban areas, having no occupation) did not follow a consistent grammatical pattern. This was revised to ensure structural uniformity and coherence. Redundancy (“a married spouse”): The phrase “a married spouse” was redundant, as the term “spouse” inherently implies marriage. This might be corrected by using “married” to describe participant marital status. Stylistic improvement (“having no occupation”): The phrase “having no occupation” might be replace with “unemployed”, which is more concise and aligns with formal academic style. Refined causal phrasing: The expression “at higher risk for PTB due to depression during pregnancy” might be modify to “at higher risk of PTB associated with depression during pregnancy”, providing a more precise and neutral description of the relationship. 2. Group Sizes and Balance: The number of animals in the control group is smaller than in the experimental group. The authors should justify this discrepancy statistically or, if feasible, increase the number of control animals to achieve a more balanced comparison. Balanced group sizes are critical not only for valid statistical analysis but also for the credibility and robustness of the conclusions. 3. Animal Welfare Considerations: The study could be improved by implementing refined animal-handling techniques to further reduce stress in the mice. For instance, using handling tunnels rather than direct tail handling is recommended, as this approach has been shown to reduce anxiety-related behaviors and improve animal welfare. In future studies, the authors are encouraged to strengthen animal welfare practices to align with best practices in laboratory animal care. Minimizing stress not only has ethical benefits but may also enhance the reliability of behavioral and physiological outcomes. 4. Characterization of the Human Study Group: Providing a more detailed analysis of the clinical background and characteristics of depression in women aged 25–34 would strengthen the study. Relevant information could include: � Duration and severity of depressive episodes, � Previous psychiatric history, � Use of antidepressants or other medications, � Psychosocial factors such as socioeconomic status, social support, or stressful life events, � Presence of comorbidities or other medical conditions. Including these details would allow for a more precise interpretation of the findings, increase the scientific rigor of the conclusions, and provide context for understanding the observed effects. 5. Human Study Sample Size: The study’s sample of women affected by depression during pregnancy is relatively small. It is commendable that the authors included this point in the manuscript’s limitations section. Highlighting this constraint strengthens the transparency of the study and appropriately informs readers about its potential impact on the reliability of the findings. Conclusion: Overall, the study is innovative, relevant, and methodologically robust. Enhancing language clarity, adopting more precise terminology, justifying group sizes, implementing refined animal-handling practices, increasing attention to animal welfare, and providing a more detailed characterization of the human study group would significantly strengthen the manuscript and prepare it for publication consideration. ********** 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 #3: No Reviewer #4: No Reviewer #5: No Reviewer #6: No Reviewer #7: Yes: Katarzyna Dominika Kopaczka ********** [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.] To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation. NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications. |
| Revision 2 |
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Dear Dr. Chen, Please submit your revised manuscript by Feb 04 2026 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.
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, Samson Nivins, Ph.D Academic Editor PLOS One Journal Requirements: If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: All my comments were adequately addressed. Just do the corrections suggested by one of the reviewer. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #5: All comments have been addressed Reviewer #7: (No Response) ********** 2. Is the manuscript technically sound, and do the data support the conclusions??> Reviewer #5: (No Response) Reviewer #7: Yes ********** 3. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #5: (No Response) Reviewer #7: Yes ********** 4. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #5: (No Response) Reviewer #7: Yes ********** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #5: (No Response) Reviewer #7: Yes ********** Reviewer #5: (No Response) Reviewer #7: The authors have not adequately addressed this comment in the revised manuscript. Please provide a clear response and incorporate the necessary revisions. Language and Terminology: The manuscript contains several grammatical and lexical errors that may hinder clarity. Improving language clarity will enhance both readability and credibility. Certain terms need to be revised for scientific accuracy. For example, the use of “normal mice” to describe the control group is not recommended, as it can be interpreted in a vague or colloquial manner. More appropriate terminology includes “control mice” or “non-depressed mice,” which are standard in scientific literature and precisely describe the group’s characteristics. In the previous version of the manuscript, the following sentence appeared in the Results section: “Subgroup analysis revealed that pregnant women aged 25–34 years in the second trimester with lower annual family income, higher education, living in urban areas, having no occupation, and a married spouse were at higher risk for PTB due to depression during pregnancy.” Upon review, several linguistic and stylistic issues were identified that could affect clarity and precision: Lack of parallel structure: The attributes in the list (e.g., with lower income, higher education, living in urban areas, having no occupation) did not follow a consistent grammatical pattern. This was revised to ensure structural uniformity and coherence. Redundancy (“a married spouse”): The phrase “a married spouse” was redundant, as the term “spouse” inherently implies marriage. This might be corrected by using “married” to describe participant marital status. Stylistic improvement (“having no occupation”): The phrase “having no occupation” might be replace with “unemployed”, which is more concise and aligns with formal academic style. Refined causal phrasing: The expression “at higher risk for PTB due to depression during pregnancy” might be modify to “at higher risk of PTB associated with depression during pregnancy”, providing a more precise and neutral description of the relationship. 3. Animal Welfare Considerations: In the section concerning animal welfare, it is important to emphasize the use of low-stress handling methods (e.g., using tunnels) outside of controlled procedures that may require a specific approach and tail handling. Please take this into consideration, as it may improve the quality of the results obtained. 4. Characterization of the Human Study Group:More detailed investigation of additional factors that may strongly influence depression, such as environmental conditions, social interactions, or genetic background, would help avoid false-positive or false-negative results. This is particularly important when the experimental group is small, as limited sample sizes can increase variability and reduce statistical power. Careful control and reporting of these factors would improve the reliability and interpretability of the findings. ********** 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 #5: No Reviewer #7: Yes: Katarzyna Kopaczka ********** [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.] To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation. NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications. |
| Revision 3 |
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Association between depression during pregnancy and preterm birth: results from population cohorts and mouse experimental models PONE-D-24-60622R3 Dear Dr. Chen, 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. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. For questions related to billing, please contact billing support . If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Samson Nivins, Ph.D Academic Editor PLOS One Additional Editor Comments (optional): Reviewers' comments: |
| Formally Accepted |
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PONE-D-24-60622R3 PLOS One Dear Dr. Chen, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS One. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. You will receive an invoice from PLOS for your publication fee after your manuscript has reached the completed accept phase. If you receive an email requesting payment before acceptance or for any other service, this may be a phishing scheme. Learn how to identify phishing emails and protect your accounts at https://explore.plos.org/phishing. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Samson Nivins Academic Editor PLOS One |
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