Background
Whether research engagement on social media and other public platforms results in increased citations in obstetrics and gynecology remains uncertain. The Altmetric Attention Score is a metric of research influence based on mentions on social media and public platforms, such as newsfeeds and Wikipedia. The correlation between Altmetric Attention Scores, absolute citation rates, and the Relative Citation Ratio (a novel metric of research engagement also based on citation rates) in obstetrics and gynecology research is uncertain.
Objective
To evaluate the correlation between Altmetric Attention Score, absolute citation rate, and Relative Citation Ratio for articles published in obstetrics and gynecology journals from 2004 to 2019. Our second objective was to identify, characterize, and compare the 100 articles with highest Altmetric Attention Scores, the 100 most-cited articles, and the 100 articles with highest Relative Citation Ratios.
Study Design
We performed a cross-sectional altmetric and bibliometric study of all obstetrics and gynecology articles indexed in the National Institutes of Health Open Citation Collection from 2004 to 2019. Articles were included if they were published in obstetrics and gynecology journals according to InCites Journal Citation Reports indexing. Citation data, including citation numbers and Relative Citation Ratios, were downloaded on March 20, 2021 and merged with altmetric data from the Altmetric Explorer on the basis of each article’s unique PubMed identification number. We assessed correlation between Altmetric Attention Scores and number of citations and Altmetric Attention Scores and Relative Citation Ratios by calculating the Pearson correlation coefficient. The 100 articles with highest Altmetric Attention Scores, the 100 most-cited articles, and the 100 articles with highest Relative Citation Ratios were characterized and compared using means (standard deviations) and mean differences (95% confidence intervals).
Results
There were 156,592 articles published in 82 obstetrics and gynecology journals and indexed in the National Institutes of Health Open Citation Collection between 2004 and 2019. The correlation coefficient was 0.18 (95% confidence interval, 0.17–0.19) for Altmetric Attention Scores vs number of citations and 0.10 (95% confidence interval, 0.09–0.11) for Altmetric Attention Scores vs Relative Citation Ratios. There was no overlap among the 100 articles on the highest Altmetric Attention Score list and the 100 most-cited list, and there was minimal overlap among the 100 articles on the highest Altmetric Attention Score list and the 100 highest Relative Citation Ratio list (98 unique articles on each list). Articles with highest Altmetric Attention Scores generated substantially more engagement on social media and other public platforms than most-cited articles (mean Altmetric Attention Score, 763.1 [standard deviation, 520.8] vs 49.9 [standard deviation, 81.6]; mean difference, −713.2 [95% confidence interval, −819.9 to −606.6]) and highest Relative Citation Ratio articles (mean, 116.2 [standard deviation, 415.9]; mean difference, −661.5 [95% confidence interval, −746.2 to −576.9]). In contrast, the articles with highest Altmetric Attention Scores generated far fewer citations than most-cited articles (mean, 39.7 [standard deviation, 47.6] vs 541.8 [standard deviation, 312.8]; mean difference, 502.0 [95% confidence interval, 439.0–565.0]) and highest Relative Citation Ratio articles (mean, 458.9 [standard deviation, 363.5]; mean difference, 427.7 [95% confidence interval, 353.8–501.6]). Nearly half of articles with highest Altmetric Attention Scores were basic/translational studies, often about menopause and environmental factors impacting fertility, whereas most-cited articles and articles with highest Relative Citation Ratios were more likely to be reviews and consensus statements, respectively, often about placentation and polycystic ovary syndrome, respectively. Articles with highest Altmetric Attention Scores were more likely to be published as open-access.
Conclusion
There seems to be weak short-term correlation between Altmetric Attention Scores and citation rates. Further study is warranted to ascertain whether there may be long-term correlation between alternative metrics and citation rates in obstetrics and gynecology.
Introduction
Bibliometrics refers to the application of statistical methods to assess the impact of research articles and other publications. Bibliometric analysis based on absolute citation rates can also be used to evaluate performance of academic journals and individual researchers. Several citation-based metrics have generated research interest, including the absolute citation number and the Relative Citation Ratio (RCR). Absolute citation number favors older articles and has limited utility when comparing articles from different fields or different subspecialties within the same field. The RCR is another citation-based metric, which is defined as the total number of citations that an article receives per year divided by the average field-specific citation rate for a peer comparison group of National Institutes of Health (NIH)-funded articles. The RCR allows comparison of articles in different fields, which is an advantage over the absolute citation number, but it is still based on citation rates, and its impact can only be assessed retrospectively.
Why was this study conducted?
This study was conducted to evaluate whether there is a correlation between engagement with obstetrics and gynecology (OB/GYN) research on social media and other public platforms and 2 citation-based metrics, including absolute citation number and the Relative Citation Ratio (RCR). We also wanted to characterize the 100 articles with highest Altmetric Attention Scores (AASs), citation rates, and RCRs to gain insight into the characteristics that lead to greater research influence according to these metrics.
Key findings
There was weak short-term correlation between AASs and citation-based metrics. Compared with most-cited articles and articles with highest RCRs, articles with highest AASs were more recently published and more likely to be open-access and have non-US authorship. Nearly half of articles with highest AASs were basic/translational studies, often about menopause and environmental factors impacting fertility, whereas most-cited and highest-RCR articles were more likely to be reviews and consensus statements, respectively, often about placentation and polycystic ovary syndrome, respectively.
What does this add to what is known?
This study quantifies the degree of correlation between AASs and 2 citation-based metrics in OB/GYN, including absolute citation number and the RCR. Although the results of this study suggest there is weak short-term correlation between engagement with OB/GYN research on social media and public platforms and 2 citation-based metrics, further study is warranted to ascertain whether there could be a stronger long-term correlation.
Because of the limitations of conventional bibliometric analysis based on citation rates, there is interest in applying alternative metrics to gauge the influence of research. One such tool is the Altmetric Attention Score (AAS), which is a composite score of research influence based on research mentions on research blogs, news media coverage, bookmarks on reference managers like Mendeley, citations on Wikipedia, and engagement on social media platforms such as Twitter and Facebook. ,
Previous bibliometric studies in obstetrics and gynecology (OB/GYN) have focused on citation rates , and the RCR, but it remains unclear whether greater research engagement with social media and public platforms results in higher citation rates. Therefore, we performed a cross-sectional altmetric and bibliometric analysis of all articles published in OB/GYN journals from 2004 to 2019. The objectives were to evaluate the correlation between AASs and 2 citation-based metrics, namely the absolute citation number and the RCR. The second objective was to identify, characterize, and compare the 100 articles with highest AASs, the 100 most-cited articles, and the 100 articles with highest RCRs. We hypothesized that there would be correlation between altmetrics and bibliometrics and that articles that generated substantial interest on social media and public platforms would share similarities with articles that generated frequent citations.
Materials and Methods
We performed a cross-sectional altmetric and bibliometric study of all OB/GYN articles published from 2004 to 2019. Given that social media companies such as Twitter and Facebook were founded in the early 2000s, we selected a period that would ensure that altmetric and bibliometric data would be available for most articles. Articles were included if they were published in “obstetrics and gynecology” journals according to InCites Journal Citation Reports (JCR), indexed in the NIH Open Citation Collection (OCC), and available for free download from the iCite website. The NIH OCC is a scientometric database derived from multiple sources including PubMed Central, MEDLINE, Entrez, and Crossref. The database also includes open-access data that is obtained through a machine learning pipeline. Because this is a publicly available database that contains no protected health information, no institutional review board approval was sought. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines for cross-sectional studies.
Data sources
InCites JCR was used to identify all active OB/GYN journals. The iCite database was queried to identify all articles published in each OB/GYN journal between 2004 and 2019 and downloaded into a Microsoft Excel (Microsoft Corporation, Redmond, WA) file. These articles were then merged by their unique PubMed identification numbers with altmetrics from the Altmetric Explorer.
Bibliometrics, altmetrics, and article characteristics
Citation numbers and RCR data were downloaded from the iCite website, and altmetric data were downloaded from Altmetric Explorer on March 20, 2021. For Altmetric data, we recorded the AAS and the number of mentions on Twitter, newsfeeds, blog posts, policy mentions, patent mentions, peer mentions, Facebook, Wikipedia, Reddit, and Mendeley for each article. For bibliometric data, we recorded the number of citations, the number of citations per year, and the RCR for each article.
To provide insight into citation rates and the characteristics of OB/GYN research that led to substantial engagement on social media and other public platforms, the 100 articles with highest AASs, the 100 most-cited articles, and the 100 articles with highest RCRs were selected for further review. These articles were characterized on the basis of previous bibliometric studies in OB/GYN , by study design, topic, open access, authorship, and country of origin. Study design included observational, basic, and translational science, randomized clinical trials (RCTs), reviews, consensus statements, new procedures, and other.
Statistical analysis
We assessed the correlation between AAS and citation rates, and the AAS and RCR, using Pearson’s correlation coefficients (with 95% confidence intervals [CIs]). We performed descriptive analyses to characterize the 100 articles that had highest AASs, were cited the most, and had highest RCRs. In addition, after excluding articles that featured on both lists, we compared characteristics of articles with the highest AASs with those of the most-cited articles, and we also compared articles with highest AASs with articles with the highest RCRs. We calculated means (standard deviations [SDs]) and mean differences with 95% CIs. All analyses were performed with Stata version 10.1 (StataCorp LP, College Station, TX).
Results
All data were downloaded on March 20, 2021. There were 156,592 articles published in 82 OB/GYN journals from 2004 to 2019. Citation data were available for 148,012 (94.5%) articles, of which 16,539 (11.2%) articles were cited 0 times, 128,991 (87.1%) were cited 1 to 99 times, and 2482 (1.7%) were cited ≥100 times ( Figure 1 ). RCR data were available for 156,223 (99.8%) articles. There were 17,444 (11.2%) articles with RCR score of 0, 138,778 (88.8%) with RCR score between 0.1 and 99.9, and 1 (0.0%) article with RCR score of ≥100. AAS was available for less than half (77,207 [49.3%]) of articles with citation data, indicating that nearly half of published articles during the study period had no public footprint. Of these articles, there were 18,331 (23.7%) with AASs of 0, 58,128 (75.3%) with AASs between 1 and 99, and 748 (1.0%) with AASs >100. The correlation coefficient was 0.18 (95% CI, 0.17–0.19) for AASs vs number of citations and 0.10 (95% CI, 0.09–0.11) for AASs vs RCRs.
Characteristics of the 100 articles with highest AASs, the 100 most-cited articles, and the 100 articles with highest RCRs are summarized and compared in Table 1 . The full list of the articles can be found in the Supplemental Table . There was no overlap between the 100 articles on the highest-AAS list and the 100 most-cited list, and there was minimal overlap between the 100 articles on the highest-AAS list and the 100 highest-RCR list (98 unique articles on each list). Articles with highest AASs were more recently published and more likely to be open-access and have non-US authorship than most-cited articles and articles with highest RCRs. These articles generated substantially more engagement on social media and other public platforms than most-cited articles and highest-RCR articles. However, they also generated far fewer citations than most-cited articles (mean, 39.7 [SD, 47.6] vs 541.8 [SD, 312.8]; mean difference, 502.0 [95% CI, 439.0–565.0]) and highest-RCR articles (mean, 458.9 [SD, 363.5]; mean difference, 427.7 [95% CI, 353.8–501.6]).
| Characteristic | Top AAS N=100 | Top cited N=100 a | Top RCR N=100 b | Top AAS vs top cited c mean difference (95% CI) | Top AAS vs top RCR d mean difference (95% CI) |
|---|---|---|---|---|---|
| Year | 2015 (3) | 2008 (3) | 2012 (4) | −7.1 (−7.9 to −6.3) | −3.4 (−4.4 to −2.4) |
| Citations | 39.7 (47.6) | 541.8 (312.8) | 458.9 (363.5) | 502.0 (439.0 to 565.0) | 427.7 (353.8 to 501.6) |
| Citations per year | 7.2 (8.0) | 44.5 (27.4) | 49.5 (25.6) | 37.4 (31.7 to 43.0) | 43.2 (37.9 to 48.5) |
| RCR | 4.2 (4.7) | 23.9 (14.3) | 28.4 (12.6) | 19.6 (16.7 to 22.6) | 24.7 (22.1 to 27.3) |
| APT | 0.7 (0.3) | 0.9 (0.1) | 1.0 (0) | 0.3 (0.2 to 0.3) | 0.3 (0.2 to 0.3) |
| AAS | 763.1 (520.8) | 49.9 (81.6) | 116.2 (415.9) | −713.2 (−819.9 to −606.6) | −661.5 (−746.2 to −576.9) |
| 316.2 (1278.5) | 5.8 (17.0) | 27.5 (79.4) | −310.3 (−569.1 to −51.6) | −294.7 (−556.1 to −33.4) | |
| News | 92.3 (71.6) | 4.3 (9.0) | 12.8 (60.6) | −88.0 (−102.6 to −73.4) | −81.2 (−91.8 to −70.6) |
| Blog | 3.8 (5.8) | 1.2 (2.4) | 1.6 (4.8) | −2.6 (−3.8 to −1.3) | −2.2 (−3.2 to −1.2) |
| Policy | 0.4 (1.2) | 2.2 (3.1) | 2.5 (5.5) | 1.7 (1.1 to 2.4) | 2.1 (0.9 to 3.2) |
| Patent | 0.1 (0.3) | 3.2 (11.5) | 2.2 (11.0) | 3.2 (0.9 to 5.4) | 2.2 (0 to 4.4) |
| Peer | 0 (0.1) | 0.1 (0.5) | 0.1 (0.5) | 0 (−0.1 to 0.1) | 0 (0 to 0.1) |
| 16.6 (80.9) | 0.7 (3.0) | 3.6 (9.3) | −15.9 (−32.3 to 0.6) | −13.2 (−29.6 to 3.2) | |
| Wiki | 0.4 (1.2) | 0.6 (1.2) | 0.6 (1.2) | 0.2 (−0.2 to 0.5) | 0.2 (−0.1 to 0.5) |
| 8.3 (48.8) | 0.1 (0.4) | 3.6 (9.4) | −8.1 (−18.0 to 1.7) | −8.1 (−18.1 to 1.9) | |
| 0 | 0 (0.1) | 0 (0.1) | 0 (0 to 0) | 0 ( to 0) | |
| 0.5 (1.4) | 0 (0.2) | 0.1 (0.5) | −0.4 (−0.7 to −0.2) | −0.4 (−0.7 to −0.1) | |
| Mendeley | 101.3 (94.3) | 447.3 (274.7) | 449.3 (274.4) | 346.0 (288.6 to 403.4) | 355.2 (297.7 to 412.7) |
| Open access (%) | 82 | 54 | 61 | — | — |
| United States authorship (%) | 33 | 54 | 56 | — | — |
a Altmetrics data available for n=95
b Altmetrics data available for n=97
c Includes 100 unique articles on most-cited and highest-AAS lists
d Includes 98 unique articles on highest-RCR and highest-AAS lists.
Nearly half of articles with highest AASs were basic/translational studies, whereas most-cited and highest-RCR articles were more likely to be reviews and consensus statements, respectively ( Table 2 ). Only 15 of these influential articles were RCTs, and 7 (46.7%) of them were in the most-cited list. The institutions that published the most articles are described in Table 3 . The American College of Obstetricians and Gynecologists, the NIH, the University of California, San Francisco, and the North American Menopause Society all contributed 5 or more articles. The distribution of journals that published the most articles is described in Figure 2 .
| Study design | Top AAS N=100 | Top Cited N=100 | Top RCR N=100 |
|---|---|---|---|
| Observational | 10 | 12 | 11 |
| Basic/translational science | 49 | 14 | 7 |
| Review | 12 | 29 | 19 |
| Consensus statement | 3 | 20 | 38 |
| Meta-analysis/systematic review | 5 | 15 | 20 |
| Randomized clinical trial | 5 | 7 | 3 |
| New procedure/assay | 3 | 2 | 1 |
| Other | 13 | 1 | 1 |
| Institution | Country of origin | Number of publications |
|---|---|---|
| American College of Obstetricians and Gynecologists | United States | 13 |
| National Institute of Child Health and Human Development | United States | 6 |
| University of California, San Francisco | United States | 6 |
| North American Menopause Society | United States | 5 |
Topics that featured prominently in the highest-AAS list included menopause (n=9), environmental factors that impact fertility (n=8), and abortion (n=6), whereas the placenta (n=7) and obesity in pregnancy (n=6) featured prominently in the most-cited list, and polycystic ovary syndrome (n=8) and maternal morbidity and mortality (n=7) featured prominently in the highest-RCR list.
Comment
Principal findings
In this cross-sectional altmetric and bibliometric study of articles published in OB/GYN journals between 2004 and Q4 2019, we found weak short-term correlation between AAS, a marker of research engagement with social media and public platforms, and absolute citation number. The AAS also had weak correlation with the RCR, which is a novel metric of research influence based on citation rates that has advantages over conventional citation analysis. This lack of correlation was further evident in an analysis that compared the 100 articles with highest AASs with the 100 most-cited articles and the 100 articles with highest RCRs. There was minimal overlap between these lists of influential articles, and the article characteristics were quite different. Compared with articles that received more citations (on the basis of absolute number and RCRs), articles with highest AASs were more likely to be published recently, be available as open-access, have non-US authorship, and be basic science and translational research.
Result in context
More than 70% of adults in the United States use social media, and high-impact journals use these platforms to share their research. The rationale for these efforts is based on limited evidence. For example, a 2011 study of tweets containing links to articles in the Journal of Medical Internet Research (July 2008–November 2011) found moderate correlation between “tweetations” and citations (correlation coefficients ranged from 0.4–0.7 for the log-transformed Google Scholar citations), but the authors found that articles that were highly tweeted were 11 times more likely to be highly cited articles than articles that were not highly tweeted (rate ratio, 10.8; 95% CI, 3.4–33.6). The results of 2 systematic reviews found some evidence that social media engagement may increase the number of citations that articles received, but the evidence was deemed “inconclusive” by one, and its author suggested that further high-quality studies are needed to quantify the impact of engagement with social media and public platforms on citation rates. ,
As a marker of engagement on social media and public platforms, the AAS employs machine learning algorithms to evaluate engagement on multiple platforms. In the study, we found weak correlation between AAS and 2 citation-based metrics. Although this study is the first to focus on OB/GYN research, others have suggested poor correlation between AAS and citation rates. For example, in an analysis that included all pediatric articles published in 2014 in 2 general pediatric journals ( Pediatrics and JAMA Pediatrics ) and 2 general medicine journals ( Journal of the American Medical Association and the New England Journal of Medicine ), the authors found a “modest” correlation between article citations and AASs (Spearman correlation, 0.53 [95% CI, 0.49–0.57]). Weak or no correlation was observed in influential articles in dental research, medical education, anesthesia, and radiology, among other fields. The weak correlation could mean that altmetrics reflect other dimensions of impact that are independent of citations. There is evidence that articles shared on Twitter have higher download and view rates, , which reflects “uptake” of new research. , Given that the AAS is a relatively new metric, the lack of correlation may reflect a short-term relationship. Long-term correlation between AASs and citation-based metrics in OB/GYN remains uncertain.
Articles that were highly cited had substantial engagement on Mendeley. This is consistent with previous studies. , A meta-analysis evaluating correlation between altmetrics and citation rates found no correlation with micro-blogging (Twitter), small correlation with blog counts, and moderate to large correlation with bookmark counts in Mendeley and CiteULike. Another study reported a positive correlation between traditional citations and Mendeley in all fields of academia, although the magnitude of correlation varied considerably across fields. The authors concluded that Mendeley reader counts could be used as evidence of early citation impact in most fields.
The study identified numeric differences between the study types of articles with highest AASs and frequently cited articles. Approximately half of articles with highest AASs were basic/translational studies, whereas most-cited and highest-RCR articles were more likely to be reviews and consensus statements. Although this study characterized the study types of OB/GYN articles that have substantial engagement with social media and public platforms, previous studies have evaluated study types of frequently cited OB/GYN articles. However, previous studies have evaluated study types of frequently cited OB/GYN articles. A previous study that evaluated highest-RCR and most-cited articles in OB/GYN in the NIH OCC (1980–2019) suggested that these articles were frequently reviews and consensus statements, but the most common study type was observational. In another study of OB/GYN articles that included specialty OB/GYN and nonspecialty journals in the Web of Science’s Science Citation Index Expanded (1980–2018), the most common study type among articles from specialty journals was also observational. It is possible that the short time period of our study explains the difference in results compared with these previously published studies.
Compared with most-cited articles and articles with highest RCRs, articles with highest AASs were more likely to be open-access and have non-US authorship. Reasons for these findings are not well elucidated. It is possible that open-access articles are more frequently shared on social media and other public platforms. The machine learning algorithm employed by Altmetric may also preferentially identify open-access articles, but this seems less likely. Only one-third of highest-AAS articles were published by US authors. This finding warrants further study, especially because the main social media and public platforms that are incorporated into the AAS are based in the United States.
Research implications
Despite the study findings of weak correlation between AAS and citation rates, many academic journals (and most high-impact journals) promote their research on social media and other public platforms. An analysis of more than 3000 journals indexed in Scopus demonstrated that more than 30% were linked to various social media sites. These journals use multiple strategies to promote their work on social media, such as internet-based journal clubs, podcasts and other article promotion, and sharing infographics and video abstracts. There may be several reasons why academic journals have embraced social media. There is a general sense that social media engagement has tangible, positive impact on citation rates. , Journals may also like how social media rapidly disseminates knowledge (faster than print). Engagement with research on social media provides insight into public engagement that is broader than citations, reflecting how it immediately reaches readers beyond (or perhaps in addition to) the usual research community and serves to illustrate the potential social implications of the research.
Academic journals and research institutions continue to rely on conventional bibliometrics. Impact factors are the key metric for comparing the influence of academic journals, and the H-score is a key component of professional promotion applications. Given that many academic journals and researchers are promoting their findings on these public platforms, additional study and discussion regarding the utility of these efforts and the goals of research promotion in public spheres is warranted.
Strength and limitations
Our study has several strengths. First, we evaluated correlation between alternative metrics and bibliometrics on the basis of every article published in OB/GYN journals during the study period. Second, we compared AASs to 2 citation-based metrics, including citation rates and the RCR, and still found no correlation, which strengthens our findings. Third, we applied this type of analysis specifically to OB/GYN articles, which is a unique contribution of this study.
Despite these strengths, our study has some limitations. Because the AAS is a newer metric of research impact and potential reach, we limited the study period to 15 years. This was necessary so that we could ensure that we had altmetric and bibliometric data for most articles. Even with this limited study period, <50% of all articles had an AAS and thus had no public footprint at all. As we acknowledged above, it is possible that we could not recognize a correlation with citations that requires more time to become apparent. We also limited our analysis to articles published in OB/GYN journals. Therefore, we excluded OB/GYN articles published in general medicine and surgery journals. Although a potential weakness, the study reflects correlation among articles published in OB/GYN specialty journals. It is likely that these results are generalizable to other journal articles from specialty journals in other fields, although the results may not be generalizable to highest-impact journals that are geared toward larger audiences. Finally, we must acknowledge that any discussion about metrics of research influence does not reflect quality or impact on health outcomes, which is a major limitation of these metrics and calls for improved metrics that reflect quality and engagement on social media and public platforms (as reflected by altmetrics) and impact as reflected by citation rates.
Conclusions
In this cross-sectional altmetric and bibliometric study of articles published in OB/GYN journals between 2004 and 2019, we found weak short-term correlation between AAS, a marker of research impact on social media and public platforms, and 2 citation-based metrics. We also found that there were substantial differences between articles that had more engagement on social media and public platforms and articles that received more citations. Although many academic journals and research institutions promote their findings on these public platforms, the results of the study question the utility of these efforts. Further study is warranted to ascertain whether there may be long-term correlation between altmetrics and citation rates.
Acknowledgments
Altmetric provided no-cost access to their data for this project, but were not involved in the study design, analysis, or drafting the manuscript nor did they review or approve any version of the manuscript.
Supplementary Data
Appendix
| AAS rank | Citations Rank | RCR rank | Year | Title | Journal | AAS | Citations | RCR |
|---|---|---|---|---|---|---|---|---|
| 1 | 26 | 2017 | Temporal trends in sperm count: a systematic review and meta-regression analysis. | Hum. Reprod. Update | 4030 | 198 | 28.56 | |
| 2 | 2012 | The comparative safety of legal induced abortion and childbirth in the United States. | Obstet Gynecol | 2873 | 101 | 6.98 | ||
| 3 | 2016 | Recent Increases in the U.S. Maternal Mortality Rate: Disentangling Trends From Measurement Issues. | Obstet Gynecol | 2743 | 147 | 17.42 | ||
| 4 | 2013 | Attractiveness of women with rectovaginal endometriosis: a case-control study. | Fertil Steril | 1884 | 8 | 0.6 | ||
| 5 | 2018 | Pre-pregnancy fast food and fruit intake is associated with time to pregnancy. | Hum. Reprod. | 1583 | 8 | 1.91 | ||
| 6 | 2018 | Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. | Hum. Reprod. | 1535 | 17 | 3.06 | ||
| 7 | 2017 | Live birth derived from oocyte spindle transfer to prevent mitochondrial disease. | Reprod. Biomed. Online | 1525 | 81 | 8.13 | ||
| 8 | 2018 | Type of underwear worn and markers of testicular function among men attending a fertility center. | Hum. Reprod. | 1456 | 5 | 1.67 | ||
| 9 | 2017 | Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners’ Oral Contraception Study. | Am. J. Obstet. Gynecol. | 1318 | 53 | 7.68 | ||
| 10 | 2012 | Preventing unintended pregnancies by providing no-cost contraception. | Obstet Gynecol | 1287 | 176 | 11.66 | ||
| 11 | 2015 | Incidence of emergency department visits and complications after abortion. | Obstet Gynecol | 1128 | 69 | 7.44 | ||
| 12 | 2016 | Lifestyle and pregnancy loss in a contemporary cohort of women recruited before conception: The LIFE Study. | Fertil. Steril. | 1107 | 27 | 3.08 | ||
| 13 | 2016 | Semen quality of young adult ICSI offspring: the first results. | Hum. Reprod. | 1062 | 48 | 4.85 | ||
| 14 | 2017 | Safety of Medical Abortion Provided Through Telemedicine Compared With In Person. | Obstet Gynecol | 916 | 28 | 4.79 | ||
| 15 | 2017 | Response: inconsistency in ‘three-parent’ IVF study. | Reprod. Biomed. Online | 900 | 1 | 0.08 | ||
| 16 | 2017 | Corrigendum to ‘Pregnancy derived from human zygote pronuclear transfer in a patient who had arrested embryos after IVF’ [Reproductive BioMedicine Online 33 (2016) 529-533]. | Reprod. Biomed. Online | 888 | 0 | 0 | ||
| 17 | 2018 | Recommendations From Cannabis Dispensaries About First-Trimester Cannabis Use. | Obstet Gynecol | 880 | 54 | 9.94 | ||
| 18 | 2017 | Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth. | Obstet Gynecol | 861 | 28 | 4.46 | ||
| 19 | 2017 | Ages at menarche and menopause and reproductive lifespan as predictors of exceptional longevity in women: the Women’s Health Initiative. | Menopause | 835 | 20 | 2.09 | ||
| 20 | 2015 | A national survey on public perceptions of miscarriage. | Obstet Gynecol | 798 | 38 | 3.69 | ||
| 21 | 2016 | Fertility awareness-based mobile application for contraception. | Eur J Contracept Reprod Health Care | 791 | 26 | 3.6 | ||
| 22 | 2016 | A limited survey-based uncontrolled follow-up study of children born after ooplasmic transplantation in a single centre. | Reprod. Biomed. Online | 776 | 15 | 1.01 | ||
| 23 | 2013 | Radioactive cesium ( 1 ³⁴Cs and 1 ³⁷Cs) content in human placenta after the Fukushima nuclear power plant accident. | J. Obstet. Gynaecol. Res. | 760 | 0.08 | |||
| 24 | 2017 | Early menarche, nulliparity and the risk for premature and early natural menopause. | Hum. Reprod. | 753 | 40 | 5.61 | ||
| 25 | 2018 | Neurokinin 3 receptor antagonism rapidly improves vasomotor symptoms with sustained duration of action. | Menopause | 753 | 16 | 2.85 | ||
| 26 | 2018 | Human placentophagy: a review. | Am. J. Obstet. Gynecol. | 739 | 8 | 3.54 | ||
| 27 | 2018 | I, Sex Robot: the health implications of the sex robot industry. | BMJ Sex Reprod Health | 720 | 5 | 1.46 | ||
| 28 | 2011 | Emergency preparedness for those who care for infants in developed country contexts. | Int Breastfeed J | 715 | 4 | 0.27 | ||
| 29 | 2015 | Habits of cell phone usage and sperm quality – does it warrant attention? | Reprod. Biomed. Online | 713 | 9 | 1.01 | ||
| 30 | 2017 | Intrauterine Device Use and Cervical Cancer Risk: A Systematic Review and Meta-analysis. | Obstet Gynecol | 706 | 7 | 0.89 | ||
| 31 | 2017 | Follicular output rate can predict clinical pregnancy in women with unexplained infertility undergoing IVF/ICSI: a prospective cohort study. | Reprod. Biomed. Online | 694 | 9 | 1.51 | ||
| 32 | 2012 | Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation. | Fertil. Steril. | 693 | 70 | 5.29 | ||
| 33 | 2016 | Practice Bulletin No. 168: Cervical Cancer Screening and Prevention. | Obstet Gynecol | 685 | 70 | 6.12 | ||
| 34 | 2010 | Clinical studies show no effects of soy protein or isoflavones on reproductive hormones in men: results of a meta-analysis. | Fertil. Steril. | 684 | 53 | 2.67 | ||
| 35 | 2008 | Soy food and isoflavone intake in relation to semen quality parameters among men from an infertility clinic. | Hum. Reprod. | 683 | 81 | 3.86 | ||
| 36 | 2016 | Characterizing the trajectories of vasomotor symptoms across the menopausal transition. | Menopause | 681 | 34 | 3.59 | ||
| 37 | 2017 | Epidemiologic Surveillance of Teenage Birth Rates in the United States, 2006-2012. | Obstet Gynecol | 678 | 4 | 0.58 | ||
| 38 | 2016 | Recurrence of Preterm Birth and Early Term Birth. | Obstet Gynecol | 658 | 23 | 2.45 | ||
| 39 | 2017 | Time to transient and stable reductions in hot flush frequency in postmenopausal women using conjugated estrogens/bazedoxifene. | Menopause | 657 | 0 | 0 | ||
| 40 | 2017 | Short-term costs of preeclampsia to the United States health care system. | Am. J. Obstet. Gynecol. | 655 | 55 | 7.55 | ||
| 41 | 2017 | Patterns of Opioid Prescription and Use After Cesarean Delivery. | Obstet Gynecol | 649 | 63 | 9.41 | ||
| 42 | 2017 | A Shared Decision-Making Intervention to Guide Opioid Prescribing After Cesarean Delivery. | Obstet Gynecol | 646 | 25 | 4.06 | ||
| 43 | 2016 | Maternal Marijuana Use and Adverse Neonatal Outcomes: A Systematic Review and Meta-analysis. | Obstet Gynecol | 640 | 63 | 7.55 | ||
| 44 | 2014 | Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. | Breastfeed Med | 635 | 69 | 4.91 | ||
| 45 | 2018 | Stress From the Neonatal Intensive Care Unit to Home: Paternal and Maternal Cortisol Rhythms in Parents of Premature Infants. | J Perinat Neonatal Nurs | 629 | 1 | 0.59 | ||
| 46 | 2018 | Metaphase II oocytes from human unilaminar follicles grown in a multi-step culture system. | Mol. Hum. Reprod. | 625 | 60 | 11.26 | ||
| 47 | 2016 | Compounded non-FDA-approved menopausal hormone therapy prescriptions have increased: results of a pharmacy survey. | Menopause | 624 | 16 | 1.66 | ||
| 48 | 2011 | The effect of late pregnancy consumption of date fruit on labour and delivery. | J Obstet Gynaecol | 620 | 9 | 0.62 | ||
| 49 | 2015 | Enhancing Participation in Depression Care in Outpatient Perinatal Care Settings: A Systematic Review. | Obstet Gynecol | 619 | 43 | 4.63 | ||
| 50 | 2016 | Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators. | Contraception | 619 | 13 | 1.59 | ||
| 51 | 2017 | Postdischarge Opioid Use After Cesarean Delivery. | Obstet Gynecol | 618 | 39 | 5.98 | ||
| 52 | 2012 | Costs of necrotizing enterocolitis and cost-effectiveness of exclusively human milk-based products in feeding extremely premature infants. | Breastfeed Med | 615 | 107 | 6.57 | ||
| 53 | 2007 | Spontaneous delivery is related to barometric pressure. | Arch. Gynecol. Obstet. | 605 | 9 | 0.44 | ||
| 54 | 2018 | Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review. | Obstet Gynecol | 600 | 15 | 5.91 | ||
| 55 | 2015 | Sugar-sweetened beverage consumption and age at menarche in a prospective study of US girls. | Hum. Reprod. | 596 | 32 | 2.45 | ||
| 56 | 2016 | Comparing blastocyst quality and live birth rates of intravaginal culture using INVOcell™ to traditional in vitro incubation in a randomized open-label prospective controlled trial. | J. Assist. Reprod. Genet. | 591 | 5 | 0.62 | ||
| 57 | 2019 | Uterine transplantation in transgender women. | BJOG | 580 | 14 | 7.34 | ||
| 58 | 2017 | The age of fathers in the USA is rising: an analysis of 168 867 480 births from 1972 to 2015. | Hum. Reprod. | 576 | 41 | 5.44 | ||
| 59 | 2015 | Efficacy and safety of medical abortion using mifepristone and buccal misoprostol through 63 days. | Contraception | 574 | 19 | 2.21 | ||
| 60 | 2016 | Introducing precise genetic modifications into human 3PN embryos by CRISPR/Cas-mediated genome editing. | J. Assist. Reprod. Genet. | 561 | 124 | 7.44 | ||
| 61 | 2013 | Understanding why women seek abortions in the US. | BMC Womens Health | 559 | 49 | 4.11 | ||
| 62 | 2018 | ‘Man Up’: the importance and strategy for placing male reproductive health centre stage in the political and research agenda. | Hum. Reprod. | 558 | 25 | 6 | ||
| 63 | 2008 | Female sexual function and pelvic floor disorders. | Obstet Gynecol | 554 | 88 | 4.81 | ||
| 64 | 2011 | Abortion provision among practicing obstetrician-gynecologists. | Obstet Gynecol | 553 | 32 | 2.16 | ||
| 65 | 2018 | Not time to abandon use of local vaginal hormone therapies. | Menopause | 552 | 6 | 1.9 | ||
| 66 | 2017 | Zika Risk and Pregnancy in Clinical Practice: Ongoing Experience as the Outbreak Evolves. | Obstet Gynecol | 551 | 5 | 0.57 | ||
| 67 | 2017 | Geographic Comparison of Women in Academic Obstetrics and Gynecology Department-Based Leadership Roles. | Obstet Gynecol | 540 | 5 | 0.86 | ||
| 68 | 2017 | Geographic access to assisted reproductive technology health care in the United States: a population-based cross-sectional study. | Fertil. Steril. | 538 | 5 | 0.81 | ||
| 69 | 2016 | The first clinical nuclear transplantation in China: new information about a case reported to ASRM in 2003. | Reprod. Biomed. Online | 535 | 0 | 0 | ||
| 70 | 2017 | Maternal marijuana use, adverse pregnancy outcomes, and neonatal morbidity. | Am. J. Obstet. Gynecol. | 534 | 38 | 5.98 | ||
| 71 | 2016 | Timing and persistence of effect of conjugated estrogens/bazedoxifene in postmenopausal women. | Menopause | 528 | 5 | 0.5 | ||
| 72 | 2016 | Health Care System Measures to Advance Preconception Wellness: Consensus Recommendations of the Clinical Workgroup of the National Preconception Health and Health Care Initiative. | Obstet Gynecol | 521 | 24 | 3.16 | ||
| 73 | 2010 | Soybean isoflavone exposure does not have feminizing effects on men: a critical examination of the clinical evidence. | Fertil. Steril. | 520 | 24 | 1.24 | ||
| 74 | 2017 | First birth following spindle transfer for mitochondrial replacement therapy: hope and trepidation. | Reprod. Biomed. Online | 518 | 24 | 1.85 | ||
| 75 | 2018 | Using evidence to guide abortion law reform on the Isle of Man. | BMJ Sex Reprod Health | 513 | 0 | 0 | ||
| 76 | 2015 | Aberrant sperm DNA methylation predicts male fertility status and embryo quality. | Fertil. Steril. | 512 | 65 | 4.36 | ||
| 77 | 2013 | Inactivated influenza vaccine during pregnancy and risks for adverse obstetric events. | Obstet Gynecol | 508 | 48 | 2.75 | ||
| 78 | 2017 | Changing the conversation about hormone therapy. | Menopause | 508 | 3 | 0.41 | ||
| 79 | 2018 | Health Care Disparity and Pregnancy-Related Mortality in the United States, 2005-2014. | Obstet Gynecol | 499 | 21 | 5.05 | ||
| 80 | 2018 | Prevalence of Depression Among Women of Reproductive Age in the United States. | Obstet Gynecol | 499 | 7 | 2.14 | ||
| 81 | 2017 | Comparison of Tissue Yield Using Frictional Fabric Brush Versus Sharp Curettage For Endocervical Curettage. | J Low Genit Tract Dis | 499 | 0 | |||
| 82 | 2014 | In vitro effects of coital lubricants and synthetic and natural oils on sperm motility. | Fertil. Steril. | 496 | 8 | 0.72 | ||
| 83 | 39 | 2018 | Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014. | Contraception | 493 | 100 | 26.25 | |
| 84 | 2017 | Experiences and characteristics of women seeking and completing at-home medical termination of pregnancy through online telemedicine in Ireland and Northern Ireland: a population-based analysis. | BJOG | 493 | 24 | 4.33 | ||
| 85 | 2007 | Thermal asymmetry of the human scrotum. | Hum. Reprod. | 493 | 7 | 0.33 | ||
| 86 | 2014 | Seasonal ambient air pollution correlates strongly with spontaneous abortion in Mongolia. | BMC Pregnancy Childbirth | 492 | 23 | 1.71 | ||
| 87 | 2016 | Human amniotic fluid: a source of stem cells for possible therapeutic use. | Am. J. Obstet. Gynecol. | 492 | 13 | 1.2 | ||
| 88 | 2014 | Therapeutic potential of amniotic-fluid-derived stem cells on liver fibrosis model in mice. | Taiwan J Obstet Gynecol | 492 | 6 | 0.39 | ||
| 89 | 2012 | Progesterone and preterm birth prevention: translating clinical trials data into clinical practice. | Am. J. Obstet. Gynecol. | 489 | 172 | 10.82 | ||
| 90 | 2004 | Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. | Am. J. Obstet. Gynecol. | 484 | 292 | 8.16 | ||
| 91 | 2016 | Stem cells from amniotic fluid–Potential for regenerative medicine. | Best Pract Res Clin Obstet Gynaecol | 482 | 13 | 1.15 | ||
| 92 | 2014 | Amniotic fluid-derived mesenchymal stem cells: characteristics and therapeutic applications. | Arch. Gynecol. Obstet. | 482 | 13 | 0.8 | ||
| 93 | 2017 | Disparities in Chronic Conditions Among Women Hospitalized for Delivery in the United States, 2005-2014. | Obstet Gynecol | 480 | 43 | 6.55 | ||
| 94 | 2013 | Therapeutic bed rest in pregnancy: unethical and unsupported by data. | Obstet Gynecol | 480 | 17 | 1.19 | ||
| 95 | 2013 | Activity restriction among women with a short cervix. | Obstet Gynecol | 477 | 23 | 1.62 | ||
| 96 | 2017 | Reduction of severe maternal morbidity from hemorrhage using a state perinatal quality collaborative. | Am. J. Obstet. Gynecol. | 475 | 59 | 10.27 | ||
| 97 | 2017 | Longitudinal analysis of changes in weight and waist circumference in relation to incident vasomotor symptoms: the Study of Women’s Health Across the Nation (SWAN). | Menopause | 474 | 18 | 2.6 | ||
| 98 | 2015 | Pregnancy-related mortality in California: causes, characteristics, and improvement opportunities. | Obstet Gynecol | 473 | 91 | 8.24 | ||
| 99 | 2014 | Decisions for the IVF laboratory: comparative analysis of embryo culture incubators. | Reprod. Biomed. Online | 472 | 16 | 1.34 | ||
| 100 | 2017 | The accuracy of cell-free fetal DNA-based non-invasive prenatal testing in singleton pregnancies: a systematic review and bivariate meta-analysis. | BJOG | 471 | 79 | 12.37 | ||
| 1 | 2 | 2004 | Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). | Hum. Reprod. | 19 | 2653 | 89.74 | |
| 2 | 1 | 2013 | Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. | Obstet Gynecol | 28 | 1736 | 107.93 | |
| 3 | 3 | 2005 | Perinatal depression: a systematic review of prevalence and incidence. | Obstet Gynecol | 189 | 1371 | 52.77 | |
| 4 | 12 | 2008 | MicroRNA signatures of tumor-derived exosomes as diagnostic biomarkers of ovarian cancer. | Gynecol. Oncol. | 37 | 1366 | 38.38 | |
| 5 | 5 | 2010 | World Health Organization reference values for human semen characteristics. | Hum. Reprod. Update | 261 | 1027 | 48.09 | |
| 6 | 9 | 2009 | The global impact of pre-eclampsia and eclampsia. | Semin. Perinatol. | 75 | 1025 | 42.53 | |
| 7 | 6 | 2011 | Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. | BJOG | 61 | 847 | 47.24 | |
| 8 | 16 | 2009 | The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. | Fertil. Steril. | 0 | 845 | 36.16 | |
| 9 | 40 | 2004 | A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. | Gynecol. Oncol. | 7 | 844 | 26.01 | |
| 10 | 21 | 2007 | International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. | Hum. Reprod. | 62 | 818 | 30.61 | |
| 11 | 27 | 2004 | Prevalence of depression during pregnancy: systematic review. | Obstet Gynecol | 25 | 782 | 28.55 | |
| 12 | 19 | 2010 | The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. | Hum. Reprod. | 303 | 731 | 32.2 | |
| 13 | 8 | 2011 | Unintended pregnancy in the United States: incidence and disparities, 2006. | Contraception | 134 | 715 | 43.46 | |
| 14 | 20 | 2006 | Maternal morbidity associated with multiple repeat cesarean deliveries. | Obstet Gynecol | 453 | 679 | 32.01 | |
| 15 | 42 | 2005 | ESHRE guideline for the diagnosis and treatment of endometriosis. | Hum. Reprod. | 37 | 679 | 25.85 | |
| 16 | 68 | 2004 | Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. | Mol. Hum. Reprod. | 6 | 673 | 22.72 | |
| 17 | 67 | 2006 | The preterm parturition syndrome. | BJOG | 3 | 650 | 22.77 | |
| 18 | 4 | 2014 | ESHRE guideline: management of women with endometriosis. | Hum. Reprod. | 119 | 646 | 51.54 | |
| 19 | 15 | 2011 | ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. | Hum. Reprod. | 0 | 641 | 36.54 | |
| 20 | 64 | 2005 | Highly efficient vitrification method for cryopreservation of human oocytes. | Reprod. Biomed. Online | 4 | 632 | 23.56 | |
| 21 | 14 | 2011 | Contraceptive failure in the United States. | Contraception | 369 | 627 | 36.77 | |
| 22 | 75 | 2004 | Maternal morbid obesity and the risk of adverse pregnancy outcome. | Obstet Gynecol | 18 | 620 | 21.97 | |
| 23 | 54 | 2007 | Trends in neonatal morbidity and mortality for very low birthweight infants. | Am. J. Obstet. Gynecol. | 9 | 604 | 24.21 | |
| 24 | 84 | 2004 | Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis. | Obstet Gynecol | 9 | 593 | 21.01 | |
| 25 | 63 | 2006 | A systematic review of tests predicting ovarian reserve and IVF outcome. | Hum. Reprod. Update | 10 | 590 | 23.57 | |
| 26 | 18 | 2012 | Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. | Fertil. Steril. | 51 | 586 | 33.49 | |
| 27 | 46 | 2005 | Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). | Am. J. Obstet. Gynecol. | 6 | 571 | 25.11 | |
| 28 | 28 | 2009 | Still too far to walk: literature review of the determinants of delivery service use. | BMC Pregnancy Childbirth | 13 | 555 | 28.55 | |
| 29 | 59 | 2008 | Oxidative stress and male infertility–a clinical perspective. | Hum. Reprod. Update | 6 | 551 | 23.77 | |
| 30 | 2006 | The uterine spiral arteries in human pregnancy: facts and controversies. | Placenta | 2 | 548 | 16.86 | ||
| 31 | 11 | 2014 | The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. | Pregnancy Hypertens | 546 | 39.66 | ||
| 32 | 2004 | Obesity, obstetric complications and cesarean delivery rate–a population-based screening study. | Am. J. Obstet. Gynecol. | 129 | 535 | 19.44 | ||
| 33 | 2005 | Sex hormones and the immune response in humans. | Hum. Reprod. Update | 14 | 525 | 15.4 | ||
| 34 | 50 | 2008 | Sexual problems and distress in United States women: prevalence and correlates. | Obstet Gynecol | 181 | 518 | 24.46 | |
| 35 | 49 | 2010 | Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. | Obstet Gynecol | 88 | 516 | 24.53 | |
| 36 | 36 | 2011 | The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. | Hum. Reprod. | 10 | 505 | 27.03 | |
| 37 | 57 | 2011 | The “Great Obstetrical Syndromes” are associated with disorders of deep placentation. | Am. J. Obstet. Gynecol. | 18 | 503 | 23.93 | |
| 38 | 62 | 2005 | Abnormal placentation: twenty-year analysis. | Am. J. Obstet. Gynecol. | 47 | 499 | 23.6 | |
| 39 | 2007 | The role of inflammation and infection in preterm birth. | Semin. Reprod. Med. | 493 | 16.53 | |||
| 40 | 73 | 2004 | Abdominal sacrocolpopexy: a comprehensive review. | Obstet Gynecol | 12 | 491 | 22.27 | |
| 41 | 85 | 2007 | Rates of caesarean section: analysis of global, regional and national estimates. | Paediatr Perinat Epidemiol | 38 | 481 | 20.85 | |
| 42 | 2007 | 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. | Am. J. Obstet. Gynecol. | 21 | 476 | 18.36 | ||
| 43 | 100 | 2010 | Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. | Hum. Reprod. Update | 13 | 475 | 19.48 | |
| 44 | 71 | 2009 | International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. | Fertil. Steril. | 17 | 471 | 22.47 | |
| 45 | 2007 | Gestational weight gain and child adiposity at age 3 years. | Am. J. Obstet. Gynecol. | 21 | 470 | 17.51 | ||
| 46 | 2006 | Adult consequences of fetal growth restriction. | Clin Obstet Gynecol | 26 | 470 | 16.14 | ||
| 47 | 2006 | The short- and long-term implications of maternal obesity on the mother and her offspring. | BJOG | 17 | 467 | 15.6 | ||
| 48 | 45 | 2010 | Risk factors for depressive symptoms during pregnancy: a systematic review. | Am. J. Obstet. Gynecol. | 61 | 465 | 25.23 | |
| 49 | 61 | 2012 | Pathogenesis and pathophysiology of endometriosis. | Fertil. Steril. | 8 | 461 | 23.64 | |
| 50 | 82 | 2009 | Self-selection and bias in a large prospective pregnancy cohort in Norway. | Paediatr Perinat Epidemiol | 8 | 454 | 21.25 | |
| 51 | 2009 | Rheological and physiological consequences of conversion of the maternal spiral arteries for uteroplacental blood flow during human pregnancy. | Placenta | 2 | 453 | 18.04 | ||
| 52 | 2006 | The Dutch famine and its long-term consequences for adult health. | Early Hum. Dev. | 101 | 445 | 12.45 | ||
| 53 | 2008 | Oocyte-secreted factors: regulators of cumulus cell function and oocyte quality. | Hum. Reprod. Update | 28 | 436 | 15.88 | ||
| 54 | 2004 | Decidual and peripheral blood CD4+CD25+ regulatory T cells in early pregnancy subjects and spontaneous abortion cases. | Mol. Hum. Reprod. | 3 | 436 | 11.06 | ||
| 55 | 56 | 2011 | Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. | Ultrasound Obstet Gynecol | 74 | 433 | 23.97 | |
| 56 | 2006 | Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. | Am. J. Obstet. Gynecol. | 6 | 423 | 13.32 | ||
| 57 | 17 | 2016 | Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? | Ultrasound Obstet Gynecol | 299 | 421 | 35.15 | |
| 58 | 2009 | The detection of differentially expressed microRNAs from the serum of ovarian cancer patients using a novel real-time PCR platform. | Gynecol. Oncol. | 9 | 412 | 12.39 | ||
| 59 | 94 | 2010 | Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). | Hum. Reprod. Update | 22 | 409 | 20.06 | |
| 60 | 2004 | 2nd to 4th digit ratios, fetal testosterone and estradiol. | Early Hum. Dev. | 149 | 409 | 14 | ||
| 61 | 96 | 2009 | Maternal near miss–towards a standard tool for monitoring quality of maternal health care. | Best Pract Res Clin Obstet Gynaecol | 9 | 406 | 20.02 | |
| 62 | 2008 | Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. | Gynecol. Oncol. | 21 | 403 | 15.92 | ||
| 63 | 86 | 2011 | Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. | Fertil. Steril. | 150 | 401 | 20.47 | |
| 64 | 2007 | Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. | J. Matern. Fetal. Neonatal. Med. | 17 | 401 | 17.47 | ||
| 65 | 2005 | Subclinical hypothyroidism and pregnancy outcomes. | Obstet Gynecol | 7 | 401 | 15.56 | ||
| 66 | 2006 | Sperm transport in the female reproductive tract. | Hum. Reprod. Update | 118 | 398 | 14.47 | ||
| 67 | 72 | 2012 | Genome-wide fetal aneuploidy detection by maternal plasma DNA sequencing. | Obstet Gynecol | 32 | 395 | 22.45 | |
| 68 | 43 | 2013 | Practice Bulletin No. 137: Gestational diabetes mellitus. | Obstet Gynecol | 19 | 394 | 25.79 | |
| 69 | 2008 | A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for gestational age neonate. | J. Matern. Fetal. Neonatal. Med. | 4 | 394 | 15.89 | ||
| 70 | 2006 | Placenta previa, placenta accreta, and vasa previa. | Obstet Gynecol | 12 | 393 | 19.4 | ||
| 71 | 74 | 2012 | The 2012 hormone therapy position statement of: The North American Menopause Society. | Menopause | 20 | 392 | 22.09 | |
| 72 | 2009 | The two stage model of preeclampsia: variations on the theme. | Placenta | 388 | 15.54 | |||
| 73 | 79 | 2011 | Tracking of obesity-related behaviours from childhood to adulthood: A systematic review. | Maturitas | 40 | 382 | 21.76 | |
| 74 | 51 | 2013 | Mature oocyte cryopreservation: a guideline. | Fertil. Steril. | 113 | 381 | 24.43 | |
| 75 | 91 | 2009 | ACOG Practice Bulletin No. 107: Induction of labor. | Obstet Gynecol | 6 | 381 | 20.14 | |
| 76 | 66 | 2013 | 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. | Obstet Gynecol | 7 | 379 | 23.22 | |
| 77 | 2009 | A novel multiple marker bioassay utilizing HE4 and CA125 for the prediction of ovarian cancer in patients with a pelvic mass. | Gynecol. Oncol. | 16 | 374 | 12.94 | ||
| 78 | 80 | 2013 | 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. | J Low Genit Tract Dis | 17 | 374 | 21.5 | |
| 79 | 2011 | Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. | Best Pract Res Clin Obstet Gynaecol | 371 | 18.97 | |||
| 80 | 2010 | Review: Sex and the human placenta: mediating differential strategies of fetal growth and survival. | Placenta | 24 | 371 | 15.93 | ||
| 81 | 2006 | ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage. | Obstet Gynecol | 12 | 366 | 16.95 | ||
| 82 | 25 | 2013 | Risk factors for falls among older adults: a review of the literature. | Maturitas | 26 | 364 | 28.58 | |
| 83 | 2009 | Developmental origins of health and disease: brief history of the approach and current focus on epigenetic mechanisms. | Semin. Reprod. Med. | 79 | 364 | 12.98 | ||
| 84 | 2005 | Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. | Am. J. Obstet. Gynecol. | 362 | 15.57 | |||
| 85 | 2004 | Isolation of human multipotent mesenchymal stem cells from second-trimester amniotic fluid using a novel two-stage culture protocol. | Hum. Reprod. | 9 | 362 | 9.52 | ||
| 86 | 2008 | Diabetes mellitus and birth defects. | Am J Obstet Gynecol | 9 | 360 | 12.11 | ||
| 87 | 2007 | Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. | Obstet Gynecol | 5 | 359 | 18.1 | ||
| 88 | 2005 | Impact of maternal age on obstetric outcome. | Obstet Gynecol | 106 | 358 | 13.57 | ||
| 89 | 2010 | Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy. | Early Hum. Dev. | 13 | 356 | 15.55 | ||
| 90 | 2007 | Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome. | Hum. Reprod. | 1 | 355 | 15.42 | ||
| 91 | 2008 | Obesity in pregnancy stimulates macrophage accumulation and inflammation in the placenta. | Placenta | 6 | 355 | 11.92 | ||
| 92 | 2006 | Worldwide burden of gynaecological cancer: the size of the problem. | Best Pract Res Clin Obstet Gynaecol | 9 | 355 | 10.89 | ||
| 93 | 2011 | The use of morphokinetics as a predictor of embryo implantation. | Hum. Reprod. | 25 | 354 | 18.36 | ||
| 94 | 2006 | Endometrial receptivity markers, the journey to successful embryo implantation. | Hum. Reprod. Update | 7 | 354 | 11.83 | ||
| 95 | 2006 | Postmenopausal status and early menopause as independent risk factors for cardiovascular disease: a meta-analysis. | Menopause | 11 | 348 | 11.12 | ||
| 96 | 2010 | Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. | BMC Pregnancy Childbirth | 15 | 346 | 16.8 | ||
| 97 | 2010 | Uterine sarcomas: a review. | Gynecol. Oncol. | 6 | 345 | 14.09 | ||
| 98 | 2008 | Reliability, repeatability and reproducibility: analysis of measurement errors in continuous variables. | Ultrasound Obstet Gynecol | 7 | 344 | 16.41 | ||
| 99 | 2006 | A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. | Hum. Reprod. Update | 12 | 344 | 12.42 | ||
| 100 | 2008 | The use of multiple novel tumor biomarkers for the detection of ovarian carcinoma in patients with a pelvic mass. | Gynecol. Oncol. | 12 | 344 | 11.89 | ||
| 7 | 2018 | ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. | Obstet Gynecol | 22 | 204 | 45.7 | ||
| 10 | 2017 | The 2017 hormone therapy position statement of The North American Menopause Society. | Menopause | 286 | 41.53 | |||
| 13 | 2018 | Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. | Hum. Reprod. | 39 | 173 | 38.21 | ||
| 22 | 2019 | Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green-top Guideline No. 27a. | BJOG | 33 | 43 | 30.53 | ||
| 23 | 2014 | Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. | Obstet Gynecol | 54 | 334 | 29.69 | ||
| 24 | 2017 | Pregnancy-Related Mortality in the United States, 2011-2013. | Obstet Gynecol | 216 | 201 | 28.88 | ||
| 29 | 2014 | Safe prevention of the primary cesarean delivery. | Am. J. Obstet. Gynecol. | 167 | 327 | 28.51 | ||
| 30 | 2017 | The International Glossary on Infertility and Fertility Care, 2017. | Fertil. Steril. | 15 | 174 | 28.33 | ||
| 31 | 2015 | Quality of care for pregnant women and newborns-the WHO vision. | BJOG | 38 | 267 | 27.7 | ||
| 32 | 2015 | Pregnancy-related mortality in the United States, 2006-2010. | Obstet Gynecol | 144 | 294 | 27.38 | ||
| 33 | 2018 | Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. | Am. J. Obstet. Gynecol. | 431 | 105 | 27.36 | ||
| 34 | 2018 | Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. | Fertil. Steril. | 65 | 119 | 27.27 | ||
| 35 | 2018 | ART in Europe, 2014: results generated from European registries by ESHRE: The European IVF-monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE). | Hum. Reprod. | 10 | 107 | 27.09 | ||
| 37 | 2016 | WHO Statement on Caesarean Section Rates. | BJOG | 68 | 213 | 26.74 | ||
| 38 | 2016 | Consensus definition of fetal growth restriction: a Delphi procedure. | Ultrasound Obstet Gynecol | 0 | 216 | 26.61 | ||
| 41 | 2018 | ACOG Committee Opinion No. 736: Optimizing Postpartum Care. | Obstet Gynecol | 375 | 110 | 25.91 | ||
| 44 | 2018 | The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. | Pregnancy Hypertens | 15 | 112 | 25.61 | ||
| 47 | 2014 | Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery. | Obstet Gynecol | 368 | 283 | 25.07 | ||
| 48 | 2015 | ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. | Obstet Gynecol | 40 | 253 | 24.97 | ||
| 52 | 2015 | Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. | Hum. Reprod. Update | 36 | 286 | 24.4 | ||
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