This bibliometric study analyzes the main researchers, institutions, countries, and journals in the field of PE management and the relationships between them. Developments and trends in the field were analyzed by mapping keyword networks and burst keyword analysis. Finally, the results of the analysis are presented graphically through visualization software.
In this field, researchers and institutions in the United States, United Kingdom, Canada, and Australia dominate and form extensive collaborations, with Von Dadelszen P, Magee LA, Nicolaides KH, Vidler M, and others collaborating to produce the most advanced and scientific view of PE management[29–31]. The main body of research in this field is currently in developed countries, but the incidence and health effects of PE vary among different ethnic groups[32, 33], and it is some underdeveloped regions and countries that are most affected by PE. Therefore, studies on PE management need to be carried out in different races.
Since the 21st century, the Journal of maternal-fetal & neonatal medicine has published the largest number of publications in the field of PE management, and although its average number of citations is not high, it is undeniable that the journal is in a rapid stage of maturation and provides an excellent platform for the exchange of research from non-developed countries[34]. Other journals that not only have a large number of publications but are also recognized by researchers in the field (e.g. American journal of obstetrics and gynecology) often represent some new findings, perspectives, or outlooks in the field[35].
The most studied keywords in the field of PE management are focused on the risk, diagnosis, and outcome of PE[36]. For example, the expression and ratio of soluble tyrosine kinase receptor 1 (sFlt-1) and placental growth factor (PIGF) have shown good predictive and diagnostic efficacy for PE in recent studies[37], and thus a large number of investigators have investigated the relationship between sFlt-1, PlGF and PE[38]. In addition, as a multi-system disease, the symptoms of PE are often inconsistent, even without hypertension and proteinuria, PE-related symptoms may occur, so the diagnosis of PE has been under study and improvement[16]. Since there is no effective drug treatment for PE, prevention of PE is more important, and a large number of high-quality randomized controlled studies have been conducted to find a drug that can prevent the development of PE[39, 40]. It is the unanswered questions in the PE management field that have guided the research hotspots and trends and caused the burst of some keywords.
We explored keywords with high burst intensity since the 21st century, some of which erupted before or near 2000 and may have been mitigated or resolved. For example, after magnesium sulfate was widely used in PE patients to prevent eclampsia[41, 42], keywords such as severe PE, and eclampsia were no longer in burst status in the PE management field. Around 2015, researchers gradually moved deeper into the molecular field of PE management, with key molecules associated with PE pathogenesis such as soluble endoglin (sEng)[43] and sFlt-1 becoming the focus of research. In addition, due to the large number of randomized controlled trials, meta-analysis has gradually increased. Hypertensive Disorders in Pregnancy and fetal growth restriction (FGR) have the highest intensity of recent outbreak keywords. Researchers are gradually focusing on patients with hypertension but not enough to diagnose PE while studying the field of PE management; for example, hypertension in pregnancy has a higher risk of developing chronic hypertension in the postpartum period relative to PE[44]. While studying PE, FGR as a complication of PE has often received attention during PE management[45]. In addition, it is important to note that FGR is also known as intrauterine growth restriction (IUGR)[46], but IUGR ceased to be a burst keyword after 2012. We speculate that this may be related to the researchers' preference for FGR.
Our study also has some limitations. First, we only searched the WoS database, and although the WoS database is excellent, it may not include as many publications as databases such as Scopus. Second, for some early career researchers, newly created journals do not have an advantage, especially when we sorted by the total number of citations. Finally, PE management journals such as The Lancet, New England, etc. that have a small but highly influential number of publications are not shown in our figures and tables.