Disrupted Balance of the Oxidant–Antioxidant System in the Pathophysiology of Female Reproduction: Oxidative Stress and Adverse Pregnancy Outcomes

Round 1

Reviewer 1 Report

The present manuscript reviews the disrupted balance of the oxidant-antioxidant systems leading to adverse outcomes in human pregnancies. This is an excellent review of the current literature concerning the effects of reactive oxygen species on pregnancy outcomes in humans. The review format allows readers to locate specific topics of interest quickly. The figure and the tables add clarity to the manuscript.

Minor suggestions

l 118 change "estrogene" to estrogen

l 282 change "impaires" to impair

l 291 plural for types

l 369 change provides to provide (data plural)

l 462 correct spelling intrauterine

l 489, 495, 496, 544, 547, and 661 change alpha to Greek alpha

l 492 As in many

l 557 correct spelling significantly

l 558 and 597 remain (data plural)

Author Response

Thank you for your time, and the useful remarks.

l 118 change "estrogene" to estrogen  DONE

l 282 change "impaires" to impair  DONE

l 291 plural for types  DONE

l 369 change provides to provide (data plural)  DONE

l 462 correct spelling intrauterine  DONE

l 489, 495, 496, 544, 547, and 661 change alpha to Greek alpha  DONE

l 492 As in many  DONE

l 557 correct spelling significantly   DONE

l 558 and 597 remain (data plural)  DONE

Reviewer 2 Report

"Disrupted balance of the oxidant- antioxidant systems in the pathophysiology of female reproduction: oxidative stress and adverse pregnancy outcames"

The manuscript consists of 24 pages and 188 references.The topic is very interesting and relevant for the field. It fits the Journal scope. The issue concerning reproductive health is complex, multidimenshional and affects both women and men. The authors described the relations between oxidative-antioxidative stress imbalance and consequences for mother and expected child. The literature is up-to-date. Keywords are adequate and refer to the whole context. English language is understandable. The aim of the study is defined.

-I would recommend to create a graphic abstract to better visualise the issue. 

-There is no chapter which describes materials and methods. 

-Basing on which criteria did you select literature? Could you please describe it according to PRISMA guidelines?

- I would suggest to remove abbreviations list placed in the end of the article and explain it in brackets next to words in main text.

-What are the conclusions of the study? 

- Table 3 is not clear. I would divide it to processes and their consequences.

I appreciate the commitment of the Authors.

In my opinion the study may be reconsider after major revision.

Author Response

Let me thank you for your suggestions improving our paper.

I would recommend to create a graphic abstract to better visualise the issue.

We think Figure 1 is a kind of graphic abstract, which summarizes important informations of this review.

There is no chapter which describes materials and methods.

Please find the inserted section between line 22-35

Basing on which criteria did you select literature? Could you please describe it according to PRISMA guidelines?

See answer above, please find section between line 22-35

I would suggest to remove abbreviations list placed in the end of the article and explain it in brackets next to words in main text.

Thank you for the remark, the list of abbreviation is deleted and all abbreviations are placed in bracket right after the word.

What are the conclusions of the study?

As this paper is a review we did not aimed to draw any conclusion (by the way I don’t it would possible in such a kind of study), we only wanted to present the actual scale of knowledge on this area as wide as possible

Table 3 is not clear. I would divide it to processes and their consequences.

We would rather keep this table, in its present form, if you don’t mind, because we think it is more informative when processes and consequences are together presented.

Reviewer 3 Report

Dear authors,

Thank you for the paper submitted that covers an interesting topic.

The main question is about the etiological role of the disrupted oxidant-antioxidant system during human gestation in relation to adverse pregnancy outcomes.

I think the balance of oxidant and antioxidant is a trend today and has many implications for the dyad mother, foetus. The authors provide a deep and clear review of this topic and provide an accurate update.

I think this article summarises all the clinical and biochemistry information on this topic.

This article attempts to explain the effect of ROS overproduction with respect to some pathologies in pregnancy. The article is well written and flows easily.

It is a wide review that carefully explains the physiopathology of pathologies so important as preeclampsia, intrauterine growth restriction…

I have learnt a lot from reading the article and find it very interesting, which is why I think this article should be published as a consultation document for those who care about molecular biology.

Tables and figures follow the jounal´s style.

My only suggestion is to update the references. Most of them are older than five years.

Author Response

Thank you very much revising my paper, and thank you for your remarks.

My only suggestion is to update the references. Most of them are older than five years.

I tried to actualize the list of references, I marked the references after 2018 with green color in the References section. As the topic „Oxidative stress” have been a hot topic for more than 20 years, I think the 46 references after 2018 presents the actual literature in a sufficient way. On the other hand there are several papers before 2018, which are not only worth of considering to cite, but they are inevitable to be mentioned, as they build the basis of our actual knowledge.

Round 2

Reviewer 2 Report

After correction the study has improved. I would recommend to accept it in the present form.