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Top-cited articles in the Journal: a bibliometric analysis

Published:November 16, 2018DOI:https://doi.org/10.1016/j.ajog.2018.11.1091

      Background

      The Journal has had a profound influence in nearly 150 years of publishing. A bibliometric analysis, which uses citation analyses to evaluate the impact of articles, can be used to identify the most impactful papers in the Journal’s history.

      Objective

      The objective was to identify and characterize the top-cited articles published in the Journal since 1920.

      Study Design

      We used the Web of Science and Scopus databases to identify the most frequently cited articles of the Journal from 1920 through 2018. The top 100 articles from each database were included in our analysis. Articles were evaluated for several characteristics including year of publication, article type, topic, open access, and country of origin. Using the Scopus data, we performed an unadjusted categorical analysis to characterize the articles and a 2 time point analysis to compare articles before and after 1995, the median year of publication from each database list.

      Results

      The top 100 articles from each database were included in the analysis. This included 120 total articles: 80 articles listed in both and 20 unique in each database. More than half (52%) were observational studies, 9% were RCTs, and 75% were from US authors. When the post-1995 studies were compared with the articles published before 1995, articles were more frequently cited (median 27 vs 13 citations per year, P < .001), more likely to be randomized (14.0% vs 4.8%, P = .009), and more likely to originate from international authors (33.3% vs 17.5%, P = .045).

      Conclusion

      Slightly more than half of the top-cited papers in the Journal since 1920 were observational studies and three quarters of all papers were from US authors. Compared with top-cited papers before 1995, the Journal's top-cited papers after 1995 were more likely to be randomized and to originate from international authors.

      Key words

      Click Supplemental Materials under article title in Contents at ajog.org
      Evaluative bibliometrics is a field of quantitative science that uses methodologies like citation analysis to evaluate research performance.
      • Moed H.F.
      New developments in the use of citation analysis in research evaluation.
      Citation analysis utilizes citation data to quantify the impact of research as a reflection of the number of references that an article receives over time. An article that is highly cited has been critically read, deemed of value, and used to promote and defend research.

      Why was this study conducted?

      Citation analysis is a bibliometric tool that quantifies the impact of research as a reflection of the number of references that an article receives over time. As the Journal approaches its 150th anniversary, we wanted to characterize the top-cited papers in the Journal.

      Key findings

      We characterized the top-cited articles by year of publication, article type, topic, and country of origin. We found that most top-cited papers were observational studies from US authors. However, randomized trials and articles from international authors were more frequently cited after 1995 compared with articles before 1995.

      What does this add to what is known?

      This study identified some of the Journal’s most impactful papers.
      This type of bibliometric analysis is especially important in the modern context with the existence of predatory journals and variations in the peer review process.
      • Couzin-Frankel J.
      Journals under the microscope.
      Using citation analysis and other quantitative methodologies, bibliometrics can identify the most impactful papers in a journal’s history.
      Published bibliometric studies have evaluated frequently cited papers in obstetrics and gynecology and other fields of medicine.
      • Brandt J.S.
      • Downing A.C.
      • Howard D.L.
      • Kofinas J.D.
      • Chasen S.T.
      Citation classics in obstetrics and gynecology: the 100 most frequently cited journal articles in the last 50 years.
      • O’Sullivan K.E.
      • Kelly J.C.
      • Hurley J.P.
      The 100 most cited publications in cardiac surgery: a bibliometric analysis.
      • Pagni M.
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      • Cohen H.L.
      • Choudhri A.F.
      Highly cited works in radiology: the top 100 cited articles in radiologic journals.
      These studies provide insight into the important topics of each field and highlight the contributions of individual researchers and institutions. These studies can also focus on individual journals, identifying some of the most influential papers in a journal’s history.
      • Garfield E.
      100 citation classics from the Journal of the American Medical Association.
      The Journal has published scientific articles for close to 150 years. During this time, the Journal published landmark papers that shaped the scope and practice of obstetrician-gynecologists.
      • Brandt J.S.
      • Downing A.C.
      • Howard D.L.
      • Kofinas J.D.
      • Chasen S.T.
      Citation classics in obstetrics and gynecology: the 100 most frequently cited journal articles in the last 50 years.
      • Romero R.
      • TJ Garite
      • Kim M.H.
      • et al.
      The new American Journal of Obstetrics and Gynecology, 5 years later: looking back and moving forward.
      In its current form, the Journal’s influence extends across continents, reaching more than 43,000 readers in print and online each year.

      Am J Obstet Gynecol 2018. Available at: https://www.ajog.org/. Accessed March 15, 2018.

      The Journal is now one of the most impactful obstetrics and gynecology journals, ranked second to Human Reproduction Update and is the top-ranked publisher of original research in the field.
      • Romero R.
      • TJ Garite
      • Kim M.H.
      • et al.
      The new American Journal of Obstetrics and Gynecology, 5 years later: looking back and moving forward.
      To date, there has not been a bibliometric study of top-cited papers in the Journal. On the 150th anniversary of the Journal, we performed this study to identify the top-cited papers from the Journal and to see how characteristics of these publications changed over time. We hypothesized that the present analysis would identify a representative list of the Journal’s most influential papers while also providing insight into the Journal’s history and illuminating its impact on the field of obstetrics and gynecology.

      Materials and Methods

      We performed a bibliometric study looking at the top-cited articles in the Journal. We used Web of Science (of Thomas Reuters) and Scopus to identify the 100 most frequently cited articles in each database.
      Web of Science includes articles from 1980 to the present. Scopus includes articles from 1920 to the present. Although Web of Science covers the modern history of the Journal, Scopus’ data cover a greater proportion of the Journal’s publication history. We elected to use both databases to identify the most frequently cited articles because both databases have been used in other bibliometric studies.
      • Bakkalbasi N.
      • Bauer K.
      • Glover J.
      • Wang L.
      Three options for citation tracking: Google Scholar, Scopus and Web of Science.
      • Evers J.L.H.
      100 papers to read before you die.
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      • Melor H.
      • Yunus M.M.
      • Farhadi H.
      • et al.
      A Comparison between two main academic literature collections: Web of Science and Scopus databases.
      • Kulkarni A.V.
      • Aziz B.
      • Shams I.
      • Busse J.W.
      Comparisons of citations in Web of Science, Scopus, and Google Scholar for articles published in general medical journals.
      Articles were queried on Feb. 15, 2018 from Web of Science and Scopus. We identified the Journal’s publications in each database and sorted the results by number of citations. The top 100 articles in each database were independently assessed and characterized by two reviewers (S.M.Y. and H.S.P.).
      Each of the top-cited articles was evaluated for specific characteristics including the subject matter, study design, open access, and countries and institutions of origin. Subject matter was divided into 2 categories, obstetrics and gynecology, and each category was further subdivided into subspecialties including maternal-fetal medicine, benign gynecology, gynecological oncology, reproductive endocrinology and infertility, and urogynecology.
      Studies were characterized by study design. Observational studies included cohort studies, case-control studies, and case series. Studies were also characterized as basic science, review, consensus, systematic review/meta-analysis, randomized controlled trial, new procedure/assay, and other.
      Statistical analyses were performed using Stata version 10.1 (StataCorp LP, College Station, TX). The various analyses were performed using the Scopus data. We performed a descriptive analysis using a χ2 test and Fisher exact test for categorical variables and a Wilcoxon rank-sum test for nonparametric continuous variables. We evaluated median citation rates by decade of publication using the Kruskal-Wallis test. An analysis was also performed to compare articles published before and after 1995. This year was selected because it was the median year of publication in both databases.

      Results

      A total of 47,892 articles were identified in Scopus, and 41,571 articles were identified in Web of Science. Of those, 23,464 articles were cited at least once and 1292 were cited 100 or more times in Web of Science. This information could not be obtained through the Scopus database.
      Table 1 lists the top-cited articles from both databases in descending order according to the number of citations each received in Scopus. There were 120 articles in total; 80 articles were listed in both databases, whereas each contained 20 unique articles. The top-cited articles were published from 1946 to 2011. The most frequently cited article, which received 2582 citations, was published by Bump et al in 1996.
      • Bump R.C.
      • Mattiasson A.
      • Bo K.
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      The standardization of terminology of female pelvic organ prolapse and pelvic flood dysfunction.
      Table 1Top-cited papers in the Journal from 1920 through 2018 according to the number of citations in Scopus
      Citations, Scopus, nCitations, Web of Science, nAuthorsTitleYear
      25822315Bump et al
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      • et al.
      The standardization of terminology of female pelvic organ prolapse and pelvic flood dysfunction.
      The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction1996
      18101393National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy
      Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy.
      Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy2000
      14381351Roberts et al
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      Preeclampsia: an endothelial cell disorder.
      Preeclampsia: an endothelial cell disorder1989
      1100993Carpenter and Coustan
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      Criteria for screening tests for gestational diabetes.
      Criteria for screening tests for gestational diabetes1982
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      Preeclampsia: an excessive maternal inflammatory response to pregnancy.
      Preeclampsia: an excessive maternal inflammatory response to pregnancy1999
      1053
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      993Davey and MacGillivray
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      The classification and definition of the hypertensive disorders of pregnancy.
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      10531013Hadlock et al
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      Estimation of fetal weight with the use of head, body, and femur measurements—a prospective study1985
      949855Weinstein
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      Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy.
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      727NFMendelson
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      696535Delancey
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      650
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      535Crowley
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      641534Kutteh
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      589
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      526Abrams et al
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      584542Merkatz et al
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      • Johnson W.E.
      An association between low maternal serum alpha-fetoprotein and fetal chromosomal abnormalities.
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      580
      Origin outside the Untied States
      522Yoon et al
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      577
      Origin outside the Untied States
      480Dekker and Sibai
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      Etiology and pathogenesis of preeclampsia: current concepts.
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      565438DeLancey
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      The effect of diameter of largest residual disease on survival after primary cytoreductive surgery in patients with suboptimal residual epithelial ovarian carcinoma.
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      553NFCohn et al
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      546
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      528
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      520
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      ,
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      419da Fonseca et al
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      a These citations were top cited in Web of Science but not included in Scopus’ top 100
      b Origin outside the Untied States
      c Randomized controlled trial.
      The median number of citations per article was 448 (interquartile range [IQR], 382–571) with a median of 19 citations per year (IQR, 13–28) (Table 2). The number of citations per year increased each decade of the study period, from a median of 9 (IQR, 7–10) citations per year for publications from the 1940s to 32 (IQR, 26–38) citations per year for publications from the 2000s (P < .001) (Figure).
      Table 2Characteristics of top-cited papers in the Journal from 1920 through 2018
      Characteristics(n = 120)
      Year of publication1993 (1984–1999)
      United States90 (75)
      Number of citations448 (382–571)
      Citations per year19 (13–28)
      Study type
       Basic science13 (10.8)
       Observational62 (51.7)
       Review13 (10.8)
       Consensus5 (4.2)
       Systematic review/meta-analysis1 (0.8)
       Randomized controlled trial11 (9.2)
       New procedure/assay8 (6.7)
       Other7 (5.8)
      Subspecialty
       Obstetric, maternal49 (40.8)
       Obstetric, fetal30 (25)
       Gynecological oncology2 (1.7)
       Reproductive endocrinology/infertility3 (2.5)
       Urogynecology15 (12.5)
       Other benign gynecology21 (17.5)
      Open access1 (0.8)
      Data are n (percentage) or median (interquartile range). Open access is freely available for pubic access as categorized by Web of Science.
      Yadava. The Journal’s top-cited articles from 1920 through 2018. Am J Obstet Gynecol 2019.
      Figure thumbnail gr1
      FigureMedian number of citations per year by decade of publication
      The value of P < .001 was determined by the Kruskal-Wallis test for nonparametric continuous data.
      Yadava. The Journal’s top-cited articles from 1920 through 2018. Am J Obstet Gynecol 2019.
      Most of the top-cited papers were observational studies (52%) and from US authors (75%). Randomized controlled trials (RCTs) accounted for less than 10% of all articles. Obstetric publications were the most common article category, accounting for 79 of the top-cited papers (66%). There was only 1 open access article, which was published by Lancaster et al in 2010.
      • Lancaster C.A.
      • Gold K.J.
      • Flynn H.A.
      • Yoo H.
      • Marcus S.M.
      • Davis M.M.
      Risk factors for depressive symptoms during pregnancy: a systematic review.
      Information about affiliation and authors was analyzed. Most of the papers originated from academic institutions within the United States. Yale University, University of Michigan, University of Tennessee, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development each contributed 5 articles. Seoul National University, which is located in South Korea, contributed 4 articles, the most from an international institution. The author with the most publications was Dr Roberto Romero with 10. Dr Baha Sibai and Dr Bo Hyun were the next biggest contributors, with 7 and 6 articles respectively.
      We performed a 2 time point analysis comparing articles before and after 1995 (Table 3). As the Journal’s impact factor increased, we observed that the top-cited papers after 1995 were more frequently cited (median 27 citations per year [IQR, 10–17] vs 13 citations per year (IQR, 20–35), P < .001). Papers were also more likely to be randomized (4.8% vs 14.0%, P = .009) and more likely to originate from institutions outside the United States (17.5% vs 33.3%, P = .045).
      Table 3Two time point analyses comparing the Journal’s top-cited articles before and after 1995
      VariablesBefore 1995 (n = 63)After 1995 (n = 57)P value
      Years1993 (1984–1999)2013 (2010–2016)< .001
      United States52 (82.5)38 (66.7).045
      Number of citations464 (380–565)441 (389–577).89
      Citations per year14 (10–17)27 (20–35)< .001
      Study type.009
       Basic10 (15.9)3 (5.3)
       Observational31 (49.2)31 (54.4)
       Review7 (11.1)6 (10.5)
       Consensus05 (8.8)
       Systematic review/meta-analysis01 (1.8)
       Randomized controlled trial3 (4.8)8 (14)
       New procedure/assay7 (11.1)1 (1.8)
       Other5 (7.9)2 (3.5)
      Subspecialty.183
       Obstetric, maternal26 (41.3)23 (40.4)
       Obstetric, fetal17 (27)13 (22.8)
       Gynecological oncology2 (3.2)0
       Reproductive3 (4.8)0
      Endocrinology/infertility
       Urogynecology4 (6.4)11 (19.3)
       Other benign gynecology11 (17.5)10 (17.5)
      Open access01 (1.8).475
      P values were determined by χ2 or Fisher exact tests (categorical data) and Wilcoxon rank-sum test (for nonparametric continuous data). Data are n (percentage) or median (interquartile range). Open access is available for free public access.
      Yadava. The Journal’s top-cited articles from 1920 through 2018. Am J Obstet Gynecol 2019.

      Comment

      Principal findings

      In this bibliometric study, we characterized the top-cited articles published in the Journal during the last 100 years. Most papers were related to obstetrics topics and were published by authors from the United States. However, as the Journal’s influence has increased, we observed that top-cited articles published after 1995 were more frequently cited, consisted of more RCTs, and were more likely to be from international authors. When analyzed by subspecialty, there was an increase in urogynecology publications seen in more recent years.

      Results of the study in context

      We observed a larger contribution from international authors after 1995. The growing contribution of international authors in American publications is also noted in another bibliometric study.
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      looked at publication trends by Chinese authors in obstetrics and gynecology and showed more Chinese authorship in American journals. This trend may be due to multiple factors, such as changes in funding availability and research support in foreign countries. This trend may also be attributed to increasing availability of American publications online, which has been a major focus of the Journal.
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      The new American Journal of Obstetrics and Gynecology, 5 years later: looking back and moving forward.
      Top-cited articles after 1995 were more likely to be randomized controlled trials and were more frequently cited. This finding likely reflects the growing emphasis of the Journal to publish higher-quality evidence. This may also have contributed to the growing impact of the Journal as reflected in this analysis by higher citation rates.
      We also observed an increase in urogynecology publications after 1995, which corresponds with the growth of this subspecialty. The field was established in the 1970s but was expanded with the establishment of an American Board of Obstetrics and Gynecology–approved fellowship in 1995. The first National Institutes of Health request for applications for studies in urogynecology was in 1999. These milestones mirror the increase in citations in the field.

      American Urogynecologic Society (AUGS). A timeline of the development of urogynecology and female pelvic medicine and reconstructive surgery in the US, 2018. Available at: https://www.augs.org/about/history/. Accessed March 15, 2018.

      Research implications

      All of the papers in this list are important and worthy of review by practicing obstetrician-gynecologists. Our list includes the paper by Carpenter and Coustan,
      • Carpenter M.W.
      • Coustan D.R.
      Criteria for screening tests for gestational diabetes.
      which established the criteria for the diagnosis of gestational diabetes; the meta-analysis by Crowley
      • Crowley P.A.
      Antenatal corticosteroid therapy: a meta-analysis of the randomized trials, 1972 to 1994.
      that established antenatal corticosteroid therapy as an important intervention in the United States; and the description of urethral support related to incontinence by DeLancey.
      • DeLancey J.O.
      Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis.
      Publications like these have led to changes in clinical practice and opened doors for further research within the field of obstetrics and gynecology.
      A bibliometric analysis of frequently cited papers in obstetrics and gynecology journals was published in 2010.
      • Brandt J.S.
      • Downing A.C.
      • Howard D.L.
      • Kofinas J.D.
      • Chasen S.T.
      Citation classics in obstetrics and gynecology: the 100 most frequently cited journal articles in the last 50 years.
      Forty-nine of the 100 most frequently cited papers in obstetrics and gynecology were published in the Journal. Although this represented a substantial contribution to the field of obstetrics and gynecology, some of the Journal’s influential papers were not included in that analysis but were captured here.

      Strengths and limitations

      Our study has several strengths. We used 2 respected bibliometric databases. Both Web of Science and Scopus have been used for bibliometric studies.
      • Bakkalbasi N.
      • Bauer K.
      • Glover J.
      • Wang L.
      Three options for citation tracking: Google Scholar, Scopus and Web of Science.
      • Evers J.L.H.
      100 papers to read before you die.
      • Chadegani A.A.
      • Melor H.
      • Yunus M.M.
      • Farhadi H.
      • et al.
      A Comparison between two main academic literature collections: Web of Science and Scopus databases.
      • Kulkarni A.V.
      • Aziz B.
      • Shams I.
      • Busse J.W.
      Comparisons of citations in Web of Science, Scopus, and Google Scholar for articles published in general medical journals.
      Scopus is the largest abstract and citation database of peer-reviewed literature, whereas Web of Science was the first of its kind and is the most widely used bibliometric database. Neither database is accepted as superior to the other, which is why we used both for our analysis.
      There are some weaknesses to our study design. The list of top-cited articles was based on the absolute number of citations that articles received. Although this could preferentially favor older articles, nearly half of the top-cited papers were published between 1995 and 2011. There are other potential influences that may affect citation rates as well, including the availability of PubMed in 1997, journal and author self-citations, incomplete citing, and omission bias.
      • Brandt J.S.
      • Downing A.C.
      • Howard D.L.
      • Kofinas J.D.
      • Chasen S.T.
      Citation classics in obstetrics and gynecology: the 100 most frequently cited journal articles in the last 50 years.
      Another weakness is that influential papers that were not frequently cited were excluded from the database. Some papers from the Journal that have shaped the field were cited only a limited number of times until their findings became well known. This bibliometric phenomenon is referred to as obliteration by incorporation and has been demonstrated in other bibliometric studies.
      • Garfield E.
      100 citation classics from the Journal of the American Medical Association.
      The description of the Papanicolaou smear
      • Papanicolaou G.N.
      • Traut H.F.
      The diagnostic value of vaginal smears in carcinoma of the uterus.
      and the first description of fetal bradycardia
      • Morris J.M.
      The syndrome of testicular feminization in male pseudohermaphrodites.
      are 2 examples of landmark papers in the Journal that have shaped clinical practice but were not cited sufficiently to be included in this analysis. A partial list of other important papers published in the Journal that were not frequently cited was reported by Romero et al
      • Romero R.
      • TJ Garite
      • Kim M.H.
      • et al.
      The new American Journal of Obstetrics and Gynecology, 5 years later: looking back and moving forward.
      and summarized here in Table 4. While this is not a comprehensive list, it demonstrates that many papers of clinical importance are missed when looking only at citations.
      Table 4Landmark papers from the Journal not included in top-cited list
      AuthorsTitleYear
      Papanicolaou and Traut
      • Papanicolaou G.N.
      • Traut H.F.
      The diagnostic value of vaginal smears in carcinoma of the uterus.
      The diagnostic value of vaginal smears in carcinoma of the uterus1941
      Morris
      • Morris J.M.
      The syndrome of testicular feminization in male pseudohermaphrodites.
      The syndrome of testicular feminization in male pseudohermaphrodites1953
      Hon
      • Hon E.H.
      Observations on pathologic fetal bradycardia.
      Observations on pathologic fetal bradycardia1959
      Quilligan et al
      • Quilligan E.J.
      • Katigbak E.
      • Hofschild J.
      Correlation of fetal heart rate patterns and blood gas values: II, bradycardia.
      Correlation of fetal heart rate patterns and blood gas values: II, bradycardia1965
      Trierweiler et al
      • Trierweiler M.W.
      • Freeman R.K.
      • James J.
      Baseline fetal heart rate characteristics as an indicator of fetal status during the antepartum period.
      Baseline fetal heart rate characteristics as an indicator of fetal status during the antepartum period1978
      Vintzileos et al
      • Vintzileos A.M.
      • Nochimson D.J.
      • Antsaklis A.
      • Varvarigos I.
      • Guzman E.R.
      • Knuppel R.A.
      Comparison of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation in detecting fetal acidemia at birth.
      Comparison of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation in detecting fetal acidemia at birth1995
      Macones et al
      • Macones G.A.
      • Parry S.
      • Elkousy M.
      • Clothier B.
      • Ural S.H.
      • Strauss 3rd, J.F.
      A polymorphism in the promoter region of TNF and bacterial vaginosis: preliminary evidence of gene-environment interaction in the etiology of spontaneous preterm birth.
      A polymorphism in the promoter region of TNF and bacterial vaginosis: preliminary evidence of gene-environment interaction in the etiology of spontaneous preterm birth2004
      Langer et al
      • Langer O.
      • Berkus M.D.
      • Huff R.W.
      • Samueloff A.
      Shoulder dystocia: should the fetus weighing greater than or equal to 4000 grams be delivered by cesarean section?.
      Shoulder dystocia: should the fetus weighing greater than or equal to 4000 grams be delivered by cesarean section?1991
      Sibai et al
      • Sibai B.M.
      • Mercer B.M.
      • Schiff E.
      • Friedman S.A.
      Aggressive versus expectant management of severe preeclampsia at 28 to 32 weeks’ gestation: a randomized controlled trial.
      Aggressive versus expectant management of severe preeclampsia at 28 to 32 weeks’ gestation: a randomized controlled trial1994
      Burrows and Kelton
      • Burrows R.F.
      • Kelton J.G.
      Thrombocytopenia at delivery: a prospective survey of 6715 deliveries.
      Thrombocytopenia at delivery: a prospective survey of 6715 deliveries1990
      Yadava. The Journal’s top-cited articles from 1920 through 2018. Am J Obstet Gynecol 2019.

      Conclusions

      Despite these limitations, this list of top-cited papers provides insight into many of the most important papers in the Journal’s history. It provides insight into the Journal’s publications that have shaped the scope and practice of obstetrics and gynecology. As the Journal’s impact has increased, so has the quality of its publications and its international influence. We look forward to the next century of the Journal’s publications.

      Supplementary Data

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