We are writing to express our observations on the article by Le et al. (2023) that analyzed the main causal factors and prevalence of gastroesophageal reflux disease (GERD) during pregnancy, as well as the clinical manifestations and associated sociodemographic factors. Despite the thoroughness of the study, there are certain methodological aspects that could be addressed in more depth, along with other factors that were not adequately explained.1

Physical activity as a relevant factor in the prevention of GERD during pregnancy is important to highlight. A study conducted by Vera et al. described a significant association between a moderate or high level of physical activity and a lower probability of presenting with GERD, regardless of sex.2 However, upon examining the methodology employed in the original article by Le et al., the fact that these factors were not addressed or analyzed calls into question the comprehensiveness of the analysis. In addition, physical activity counteracts the progression of obesity, and in the study conducted by Valdovinos et al., obesity is identified as the main risk factor for GERD.3 Thus, considering the role of physical activity in the prevention of GERD during pregnancy acquires even greater importance.

On the other hand, the lack of clarity in the methodology regarding the collection of data on dietary habits during pregnancy and its relation to GERD makes it difficult to understand how the effects of diet on the appearance of the disease were evaluated. In this context, the study by Huerta et al. underlines how a diet rich in the fats found in sweets, and especially chocolate, increases the probability of presenting with gastroesophageal reflux during pregnancy.4

Lastly, we congratulate Le et al. on their study and recognize their important contribution to the field of medicine. Nevertheless, we believe the methodological deficiencies identified in the original article should be addressed, to provide a better understanding of the study, and thus contribute to the data supporting the importance of the relation between physical activity, dietary habits, and GERD. In turn, this will encourage future studies to delve into these aspects, resulting in a greater comprehension of the factors that influence the development of GERD in the context of pregnancy.