Adherence to research reporting guidelines is needed

Sir,

I read the article by Chauhan et al1 with great interest. In this large scale community based cross-sectional study, authors have highlighted the magnitude of chronic obstetric morbidities (COM) and the factors associated in Nashik district, Maharashtra, India. It is recommended to follow the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) checklist while reporting cross-sectional studies2. The outcome variables (prevalence of reproductive, gynaecological and chronic obstetric morbidities in this study) should have been reported with 95% confidence intervals2. Authors report that 25 (5%) of 509 women detected with any reproductive morbidity had more than one morbidity. It would be interesting to know about the proportion of women with multiple gynaecological and COMs. Further, the authors have studied the association of gynaecological and COMs with key socio-demographic, obstetric and reproductive health service related factors. In addition, exploring the association of gynaecological and COMs with place of delivery (institutional vs. Home), mode of delivery (vaginal vs. Caesarian) and source of heath care (public vs. Private) would be more informative.

The major gynaecological morbidities reported were genital candidiasis in 102 (8.7%) and vaginitis in 91 (7.8%) women. This finding has important implication in syndromic management of sexually transmitted infection/reproductive tract infection (STI/RTI) under National AIDS Control Programme in the study area. Similarly, genital prolapsed (7.1%) was the most common COM among them. There is a need to explore the possible risk factors for the same, i.e. Repeated births, lack of postnatal exercises, etc. In the study area. Such intuitive epidemiological reasoning or raising the apt research questions, keeping the socio-cultural background in mind, would be more informative and interesting. However, authors limited their discussion by comparing the results of various Indian and other studies with the present one.

According to STROBE checklist, one has to discuss limitations of the study, taking into account the sources of potential bias or imprecision2. Authors have considered a few of them such as lack of external validity and clustering effect. In addition, reported significant correlates of COM in this study may not imply causality owing to cross-sectional nature of the study. Despite these limitations, the authors need to be congratulated for exploring an important public health problem in the study area.