Objective To estimate the effect of group prenatal care on perinatal outcomes compared with traditional prenatal care. Data Sources We searched MEDLINE through PubMed, EMBASE, Scopus, Cumulative Index of Nursing and Allied Health literature [CINAHL], the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects [DARE], the Cochrane Central Register of Controlled Trials [CENTRAL]) and clinicaltrials.gov. Methods of Study Selection We searched electronic databases for randomized controlled trials (RCT) and observational studies comparing group care with traditional prenatal care. The primary outcome was preterm birth. Secondary outcomes were low birthweight (LBW), neonatal intensive care unit (NICU) admission, and breastfeeding initiation. Heterogeneity was assessed using the Q test and I2 statistic. Pooled relative risks (RRs) and weighted mean differences were calculated using random-effects models. Tabulations, Integration, and Results Four RCTs and ten observational studies met inclusion criteria. The rate of preterm birth was not significantly different with group care compared with traditional care (11 studies: pooled rates 7.9% vs. 9.3%, pooled RR 0.87; 95% CI 0.70–1.09). Group care was associated with a decreased rate of LBW overall (9 studies: pooled rate 7.5% group care vs. 9.5% traditional care; pooled RR 0.81; 95% CI 0.69–0.96), but not among RCTs (4 studies: 7.9% group care vs. 8.7% traditional care, pooled RR 0.92; 95% CI 0.73–1.16). There were no significant differences in NICU admission or breastfeeding initiation. Conclusion Available data suggest that women who participate in group care have similar rates of preterm birth, NICU admission, and breastfeeding.

Background: Alternative bibliometrics have recently been the subject of significantly increased interest. The disruption index is a new bibliometric that was recently applied to surgery and urology and identifies papers that shift paradigms and eclipse previous research in a given field. Methods: The 100 most-disruptive publications in the 14 most prominent plastic and reconstructive surgery and subspecialty journals were identified. Results: We present the 100 most-disruptive studies as well as the 100 most-cited studies for comparison in n=14 of the most popular plastic and reconstructive surgery (and subspecialty) journals between 1954 and 2014. The 100 most-disruptive publications in these journals were more disruptive than 99.8% of all PubMed papers. Plastic and Reconstructive Surgery (PRS) had the most papers in the top 100 (n=64) followed by British Journal of Plastic Surgery (currently Journal of Plastic, Reconstructive & Aesthetic Surgery, n=15), and Journal of Oral and Maxillofacial Surgery (n=7). PRS had 9 of the top 10 papers. However, Clinics in Plastic Surgery had the highest average disruption score for all its published papers (0.0029). The correlation coefficient linking disruption scores and citation counts was 0.01 and 0.11, respectively. The most common decade represented in the top 100 was the 1980's (n=31) and the least common was the 2000's (n=9). Conclusions: This is the first application of the disruption index to plastic and reconstructive surgery. The disruption score provides a unique ability to identify research that has shifted paradigms and driven the innovation that defines our specialty.

Background: We aimed to longitudinally study the relative research contributions of US and international plastic surgeons by evaluating publications within the premier plastic surgery journal over the last 2 decades. We hypothesized that even with an increased pressure to publish in this journal, the relative research contributions from American plastic surgeons will continue to be the largest overall and in all subspecialties. Methods: Data for the surgical subspecialty, corresponding author’s country of origin, and region were extracted from all original articles in 2 randomly selected monthly issues of Plastic & Reconstructive Surgery (PRS) from the last 2 decades to evaluate longitudinal trends. Data were also extracted from all of the original articles published in PRS for the last 3 years to analyze the recent distribution of research output. Results: During the last 2 decades, the relative proportion of total original articles written by US authors has increased. They have published proportionally more articles in the Reconstructive and Breast field while publishing relatively less in the hand/peripheral nerve field. From the first decade of analysis, US authors wrote relatively fewer articles in the hand/peripheral nerve field, whereas in the second decade, the US authors wrote relatively fewer articles in the Experimental field. In the last 3 years, US authors published relatively fewer articles in the Experimental and Cosmetic fields. Conclusions: Each country’s scientific productivity in PRS is related to funding, interest, patients’ demand, and healthcare market pressure. In this study, we see that these factors influence trends within research publications over the last 2 decades.