To the Editor: Although the study by Debra L. Franko, Ph.D., et al. (1) aimed to contribute to the current knowledge of mental health disorders in relation to pregnancy outcomes, it was severely limited because of research design and methods. While this longitudinal study provided much-needed groundwork for an open-ended study of eating disorders and their impact on pregnancy, it did so without a comparison group, thus limiting its generalizability. Most significant, the inferences regarding the prevalence of postpartum depression are difficult to meaningfully interpret because of the methods used and the measurement of postpartum depression. Because of the research design, it is difficult to ascertain how many women were depressed before the study and how many became depressed for other reasons. While the correlation between depression and eating disorders is certainly worthy of exploration, it is important to note that clinical depression may have been already established before the pregnancy.