BACKGROUND:The Relative Citation Ratio is a novel bibliometric tool that quantifies the impact of research articles. The objectives of this study were to identify the 100 obstetrics and gynecology articles with the highest relative citation ratios, evaluate how characteristics of these articles changed over time, and compare characteristics of these articles with topcited obstetrics and gynecology articles. OBJECTIVE: We undertook a cross-sectional bibliometric study to examine the 100 obstetrics and gynecology articles with the highest relative citation ratios and the top 100 cited articles in the National Institutes of Health Open Citations Collection from 1980 to 2019. STUDY DESIGN: We identified every obstetrics and gynecology article published from 1980 to 2019 that was indexed in the National Institutes of Health Open Citations Collection. The top 100 articles with the highest relative citation ratios and the top 100 cited articles were selected for further review. Each article was evaluated using metrics of influence, translation, and other characteristics. We compared the top 100 articles with the highest relative citation ratios published from 1980 to 1999 versus 2000 to 2019 and characteristics of the top 100 articles with the highest relative citation ratios versus the top 100 top-cited articles (after excluding those on both lists). Means, standard deviations, and mean differences with corresponding 95% confidence intervals were calculated. Associations were expressed as relative risks (95% confidence interval). RESULTS: A total of 323,673 obstetrics and gynecology articles were published between 1980 and 2019. Among the top 100 articles with the highest relative citation ratios, most were observational studies (36%), reviews (26%), and consensus statements (21%). There were only 5 randomized clinical trials. Compared with the articles with the highest relative citation ratios published from 1980 to 1999, articles published from 2000 to 2019 were more likely about benign gynecology (relative risks, 1.3; 95% confidence interval, 0.6e2.8) and less likely about gynecology-oncology (relative risks, 0.6; 95% confidence interval, 0.2e1.9) and urogynecology (relative risks, 0.6; 95% confidence interval, 0.1e3.3). The articles after 2000 were more likely about systematic reviews (relative risks, 7.7; 95% confidence interval, 1.0e58.3) and consensus statements (relative risks, 5.1; 95% confidence intervals, 1.6e16.3) and were published as open access articles (relative risks, 1.3; 95% confidence interval, 0.9e2.0). There were 60 articles in common between the top 100 articles with the highest relative citation ratios and the top 100 cited articles. Compared with articles that were top cited (after excluding articles on both lists), articles with the highest relative citation ratios received fewer mean citations (266.9 [135.3] vs 514.3 [54.6]; mean differences, 247.4; 95% confidence interval, 201.5e293.3) but had higher numbers of citations per year (37.5 [4.1] vs 31.6 [8.1]; mean difference, À5.9; 95% confiden...
INTRODUCTION: Maternal opioid use disorder (OUD) is a burgeoning public health issue with profound effects on perinatal morbidity and mortality in the US. However, whether OUD is implicated in maternal deaths, and if OUD is associated with temporal changes in maternal deaths in the US remains poorly understood. METHODS: This is a cross-sectional analysis of maternal deaths in the US from 1999–2017 using death certificate data from the Centers for Disease Control and Prevention. Maternal mortality was defined as any death during pregnancy or within 365 days after delivery. Opioid-attributable deaths were identified using ICD-10 codes. Changes in maternal mortality ratios (MMR) per 100,000 live births among OUD between 1999–00 to 2016–17 were quantified by rate ratios (RR), derived from log-linear regression models, before and after adjusting for maternal age and race/ethnicity. RESULTS: 5.6% (n=1,225) of 21,918 maternal deaths between 1999–2017 were identified as OUD-related. The overall MMR from OUD increased from 11.2 to 48.5 per 100,000 live births between 1999 to 2017, a 76.9% relative increase. The RR (95% confidence interval [CI]) of OUD-related MMR in 2000–10 and 2016–17, compared to 1999–00 (reference), were 43.1 (95% CI 13.7–135.5), and 155.0 (95% CI 49.9–483.0), respectively. By 2017, the MMR from opioids in white women increased to 5.0 per 100,000 while in black women it was 4.0 per 100,000. CONCLUSION: OUD is a growing cause of maternal mortality in the US, which affects white more than black women.
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