Faculty Bibliography

BACKGROUND:People with marginalized gender identities, including people with transgender and gender-expansive identities, have been historically excluded from research. Professional societies recommend the use of inclusive language in research, but it is uncertain how many obstetrics and gynecology journals mandate the use of gender-inclusive research practices in their author guidelines. OBJECTIVE:This study aimed to evaluate the proportion of "inclusive" journals with specific instructions about gender-inclusive research practices in their author submission guidelines; to compare these journals with "noninclusive" journals based on publisher, country of origin, and several metrics of research influence; and to qualitatively evaluate the components of inclusive research in author submission guidelines. STUDY DESIGN:A cross-sectional study of all obstetrics and gynecology journals in the Journal Citation Reports, a scientometric resource, was conducted in April 2022. Of note, One journal was indexed twice (due to a name change), and only the journal with the 2020 Journal Impact Factor was included. Author submission guidelines were reviewed by 2 independent reviewers to identify inclusive vs noninclusive journals based on whether journals had gender-inclusive research instructions. Journal characteristics, including publisher, country of origin, impact metrics (eg, Journal Impact Factor), normalized metrics (eg, Journal Citation Indicator), and source metrics (eg, number of citable items), were evaluated for all journals. The median (interquartile range) and median difference between inclusive and noninclusive journals with bootstrapped 95% confidence interval were calculated for journals with 2020 Journal Impact Factors. In addition, inclusive research instructions were thematically compared to identify trends. RESULTS:Author submission guidelines were reviewed for all 121 active obstetrics and gynecology journals indexed in the Journal Citation Reports. Overall, 41 journals (33.9%) were inclusive, and 34 journals (41.0%) with 2020 Journal Impact Factors were inclusive. Most inclusive journals were English-language publications and originated in the United States and Europe. In an analysis of journals with 2020 Journal Impact Factors, inclusive journals had a higher median Journal Impact Factor (3.4 [interquartile range, 2.2-4.3] vs 2.5 [interquartile range, 1.9-3.0]; median difference, 0.9; 95% confidence interval, 0.2-1.7) and median 5-year Journal Impact Factor (3.6 [interquartile range, 2.8-4.3] vs 2.6 [interquartile range, 2.1-3.2; median difference, 0.9; 95% confidence interval, 0.3-1.6) than noninclusive journals. Inclusive journals had higher normalized metrics, including a median 2020 Journal Citation Indicator (1.1 [interquartile range, 0.7-1.3] vs 0.8 [interquartile range, 0.6-1.0]; median difference, 0.3; 95% confidence interval, 0.1-0.5) and median normalized Eigenfactor (1.4 [interquartile range, 0.7-2.2] vs 0.7 [interquartile range, 0.4-1.5]; median difference, 0.8; 95% confidence interval, 0.2-1.5) than noninclusive journals. Moreover, inclusive journals had higher source metrics, including more citable items, total items, and Open Access Gold subscriptions, than noninclusive journals. The qualitative analysis of gender-inclusive research instructions revealed that most inclusive journals recommend that researchers use gender-neutral language and provide specific examples of inclusive language. CONCLUSION:Fewer than half of obstetrics and gynecology journals with 2020 Journal Impact Factors have gender-inclusive research practices in their author submission guidelines. This study underscores the urgent need for most obstetrics and gynecology journals to update their author submission guidelines to include specific instructions about gender-inclusive research practices.

BACKGROUND:The initial COVID-19 pandemic response-related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre-pandemic period, have been understudied. OBJECTIVES/OBJECTIVE:To examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART-conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period. METHODS:Population-based cohort study including all births in the US from January 2015 to December 2020 (22,907,688 live births; 134,537 stillbirths). Interrupted time series (ITS) methodology was used to estimate rate ratios (RR) of expected versus observed rates in December 2020 (i.e., among births conceived mainly in March 2020). Demographic and clinical characteristics were compared between mothers who conceived in March 2020 versus March 2015-2019. RESULTS:Overall, 1.1% of live births and 1.7% of stillbirths were conceived by ART. ART-conceived live births decreased by 57.0% in December 2020 (observed vs. expected RR 0.43, 95% confidence interval [CI] 0.40, 0.45), and these declines occurred in all subgroups of women. Multiple births also declined in December 2020. Stillbirth rates increased in December 2020 in ART-conceived births (RR 2.55, 95% CI 1.63, 3.92) but remained unchanged in the non-ART group. Maternal characteristics of women who conceived in the early pandemic versus pre-pandemic period differed and included an increased prevalence of pre-pregnancy obesity class 3 and chronic hypertension. CONCLUSIONS:The early pandemic closure of ART clinics resulted in a substantial decline in ART-conceived live births and multiple births in December 2020 and an increase in the proportion of stillbirths among ART-conceived births. Women who conceived in the early pandemic period also had an increased prevalence of obesity and chronic hypertension.

OBJECTIVES/OBJECTIVE:(JPM). METHODS:We performed a cross-sectional study of all JPM articles indexed in Clarivate Web of Science (WOS), NIH Open Citation Collection, and Altmetric Explorer databases (1973-2022). We identified articles cited ≥100 times in WOS and articles with highest Relative Citation Ratios (RCR, a metric of influence based on citations) and highest Altmetric Attention Scores (AAS, a metric of engagement with social media and public platforms). We performed descriptive analysis to characterize influential articles based on citation rates vs. highest AAS, and quantile regression with bootstrapping to estimate the median differences (95% confidence intervals). RESULTS:We identified 4095 JPM articles that were indexed in the WOS, of which 3,959 (96.7%) had RCRs and 939 (22.9%) had AASs. The study cohort included 34 articles cited ≥100 times and the 34 top-RCR and 34 top-AAS articles, representing 83 unique articles. These influential articles had median 67 citations (IQR 17-114), median RCR 3.4 (IQR 1.7-5.0), and median AAS 14 (IQR 3-28). The majority were observational studies and reviews. Compared to top-AAS articles, top-cited articles had higher median citations (117 [IQR 111-147] vs. 13 [IQR 5-62]; median difference 104.0, 95% CI 86.6-121.4) and citations per year (7.3 [IQR 4.9-10.6] vs. 2.3 [0.7-4.6]; median difference 5.5 [95% CI 3.1-7.9]). Results were similar for top-RCR vs. top-AAS articles. CONCLUSIONS:We identified influential articles during 50 years of JPM, providing insight into the impact of the journal and providing a template for future studies of academic journals.

Introduction Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies. Methods We screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale. Results We screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women. Pregnant women with SARS-CoV-2 infection - as compared with uninfected pregnant women - were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12). Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias. Conclusions This analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.

OBJECTIVES/OBJECTIVE:To ascertain the rate of unexpected findings on carrier screening (CS) and assess whether implications are disclosed to patients. METHODS:We performed a retrospective observational study of subjects who had CS after pre-test counseling from a licensed genetic counselor at a large tertiary care center. We quantified the rate of unexpected finding on CS, defined as manifesting carriers (MCs), genotypes predicting phenotype, and chromosome abnormalities. We determined how often patients were informed of implications. We performed subgroup analyses by type of unexpected finding and calculated odds ratios (OR) and 95% confidence intervals (CI) for carrier testing methodology (genotype) and number of genes tested. RESULTS:A total of 4685 patients had CS over the selected time frame. Of those patients, 412 patients (8.8%) had one unexpected finding and 29 patients (0.6%) had two or more findings. In total, 466 unexpected findings were identified, including 437 MC conditions, 23 genotypes predicting phenotype, and 6 chromosome abnormalities. Patients were informed of the implications for MCs, genotypes predicting phenotype, and chromosome abnormalities in 27.6%, 91.3%, and 100% of cases, respectively. More unexpected findings were detected with sequencing compared to genotyping (OR 2.21 and 95% CI 1.76-2.76) and with ≥200 gene panels compared to <200 gene panels (OR 1.79 and 95% CI 1.47-2.17). CONCLUSION/CONCLUSIONS:This study highlights that nondisclosure of unexpected findings on CS is common and underscores the need for further research to improve post-test counseling and follow-up.