Objective To describe prominent authorship positions held by women and the overall percentage of women co-authoring manuscripts submitted during the covid-19 pandemic compared with the previous two years. Design Cross sectional study. Setting Nine specialist and two large general medical journals. Population Authors of research manuscripts submitted between 1 January 2018 and 31 May 2021. Main outcome measures Primary outcome: first author’s gender. Secondary outcomes: last and corresponding authors’ gender; number (percentage) of women on authorship byline in “pre-pandemic” period (1 January 2018 to 31 December 2019) and in “covid-19” and “non-covid-19” manuscripts during pandemic. Results A total of 63 259 manuscripts were included. The number of female first, last, and corresponding authors respectively were 1313 (37.1%), 996 (27.9%), and 1119 (31.1%) for covid-19 manuscripts (lowest values in Jan-May 2020: 230 (29.4%), 165 (21.1%), and 185 (22.9%)), compared with 8583 (44.9%), 6118 (31.2%), and 7273 (37.3%) for pandemic non-covid-19 manuscripts and 12 724 (46.0%), 8923 (31.4%), and 10 981 (38.9%) for pre-pandemic manuscripts. The adjusted odds ratio of having a female first author in covid-19 manuscripts was <1.00 in all groups (P<0.001) compared with pre-pandemic (lowest in Jan-May 2020: 0.55, 98.75% confidence interval 0.43 to 0.70). The adjusted odds ratio of having a woman as last or corresponding author was significantly lower for covid-19 manuscripts in all time periods (except for the two most recent periods for last author) compared with pre-pandemic (lowest values in Jan-May 2020: 0.74 (0.57 to 0.97) for last and 0.61 (0.49 to 0.77) for corresponding author). The odds ratios for pandemic non-covid-19 manuscripts were not significantly different compared with pre-pandemic manuscripts. The median percentage of female authors on the byline was lower for covid-19 manuscripts (28.6% in Jan-May 2020) compared with pre-pandemic (36.4%) and non-covid-19 pandemic manuscripts (33.3% in Jan-May 2020). Gender disparities in all prominent authorship positions and the proportion of women authors on the byline narrowed in the most recent period (Feb-May 2021) compared with the early pandemic period (Jan-May 2020) and were very similar to values observed for pre-pandemic manuscripts. Conclusions Women have been underrepresented as co-authors and in prominent authorship positions in covid-19 research, and this gender disparity needs to be corrected by those involved in academic promotion and awarding of research grants. Women attained some prominent authorship positions equally or more frequently than before the pandemic on non-covid-19 related manuscripts submitted at some time points during the pandemic.

Objectives. To measure trends in infertility treatment use between 2008 and 2017 in France using data from the national health insurance system. Methods. Between 2008 and 2017, we observed a representative national sample of nearly 1% of all women aged 20 to 49 years who were affiliated with the main health insurance scheme in France (more than 100 000 women observed each year). We exhaustively recorded all health care reimbursed to these women. Results. Among women aged 20 to 49 years, 1.25% were treated for infertility each year. Logistic regression analysis showed a significant interaction between age and year of treatment use (P < .001). Over the decade, infertility treatment use increased by 23.9% among women aged 34 years or older, whereas among women younger than 34 years there was a nonsignificant variation. Conclusions. Women aged 34 years or older were increasingly treated for infertility between 2008 and 2017. Public Health Implications. Treatment efficiency decreases strongly with a woman’s age, presenting a challenge for medical infertility care. (Am J Public Health. Published online ahead of print July 16, 2020: e1–e3. doi:10.2105/AJPH.2020.305781)

Objectives To describe gender and geographical inequalities in invitations to review and the response to these invitations and to assess whether inequalities increased during the covid-19 pandemic. Design Retrospective cohort study. Setting 19 specialist medical journals and two large general medical journals from BMJ Publishing Group. Population Reviewers invited to review manuscripts submitted between 1 January 2018 and 31 May 2021. The cohort was followed up to 28 February 2022. Main outcome measures Reviewer’s agreement to review. Results A total of 257 025 reviewers were invited (38.6% (88 454/228 869) women), and 90 467 (35.2%) agreed to review. Invited reviewers were mainly (217 682; 84.7%) affiliated with high income countries: Europe (122 414; 47.6%), North America (66 931; 26.0%), Africa (25 735; 10.0%), Asia (22 693; 8.8%), Oceania (16 175; 6.3%), and South America (3076; 1.2%). Independent factors associated with agreement to review were gender (odds ratio 0.89, 95% confidence interval 0.87 to 0.92, for women compared with men), geographical affiliation (2.89, 2.73 to 3.06, for Asia; 3.32, 2.94 to 3.75 for South America; 1.35, 1.27 to 1.43, for Oceania; and 0.35, 0.33 to 0.37, for Africa compared with Europe), and country income (0.47, 0.45 to 0.49, for upper middle income; 5.12, 4.67 to 5.61, for lower middle income; and 4.66, 3.79 to 5.73, for low income compared with high income country). Agreement was also independently associated with editor’s gender (0.96, 0.93 to 0.99, for women compared with men), last author’s geographical affiliation (0.80, 0.78 to 0.83, for Asia; 0.89, 0.85 to 0.94, for Oceania compared with Europe), impact factor (1.78, 1.27 to 2.50, for >10 compared with <5), and type of peer review process (0.52, 0.35 to 0.77, for open compared with anonymised). During the first and second phases of the pandemic, agreement was lower than in the pre-pandemic period (P<0.001). The interaction between time periods and covid-19 related topic and reviewer’s gender was non-significant. However, significant interaction was found between time periods and covid-19 related topic and reviewer’s geographical affiliation. Conclusions To reduce bias and improve diversity, editors need to identify and implement effective strategies and continually evaluate progress against these to ensure that more women and researchers from upper middle income and low income countries are involved in review.