Welcome to our regular page of highlights from the RANZCOG peer-reviewed academic journal, ANZJOG.
First up is the news that the 2015 Journal Citation Reports1 were released in June and I am very pleased to report that ANZJOG’s 2015 Impact Factor is 1.738 – an increase to the 1.510 Impact Factor of 2014. The journal’s ranking in the Obstetrics and Gynaecology category is 43/80. This excellent increase was achieved under the editorship of my predecessor, Prof Jan Dickinson; the Associate Editors and I extend our congratulations to her.
We are sorry to announce that Dr Gerry Wain, who is retiring from gynaecological oncology practice, is also retiring from the Editorial Board, though we wish him a long and enjoyable retirement. Gerry has served as Associate Editor in his specialty since 2010, and has made a huge contribution to the journal in this area. The June issue of ANZJOG has a section devoted to Aboriginal and Torres Strait Islander women’s health, with a guest editorial from Profs Jacqueline Boyle and Sandra Eades, and four original contributions. Our guest editors, who have enormous experience in the area of Indigenous women’s health, conclude that there have been improvements at all levels of healthcare, but that inequalities persist, and ‘the reasons for these inequalities are complex’.2 They make a number of suggestions for how better outcomes might be achieved.
A study by Whish-Wilson et al3 of urban Victorian Indigenous women attending a Melbourne hospital for pregnancy care shows similar outcomes to non-Indigenous women with regard to low birthweight and preterm birth, and the incidence of diabetes in pregnancy was lower among Indigenous women attending for antenatal care than among non-Indigenous. However, smoking in pregnancy and obesity remain major problems for Indigenous women in this cohort. From Western Australia (WA) Diouf et al4 also report high levels of smoking among Indigenous women who attended for antenatal and intrapartum care across the state in 1986–2009, a higher incidence of diabetes in pregnancy, and higher risks of stillbirth, neonatal death and preterm birth than among non-Indigenous women, although there was an encouraging trend towards fewer teenage pregnancies and lower incidences of pre-eclampsia and antepartum haemorrhage. Also from WA, Bower et al5 report on the impact of the introduction of folate fortification of flour for bread-making on the red cell folate levels of a cohort of Aboriginal women and men, finding that levels have risen since a similar pre-fortification study. All participants reported eating shop-bought fortified bread at least once a week, and no participant was folate-deficient in the current study. The authors also report a 68 per cent decline in the incidence of neural tube defects as recorded in the WA Register of Developmental Anomalies, an impressive result.
Finally, among articles on Indigenous women’s health, Kandasamy et al6, in an opinion piece, note that stillbirth (SB) rates have remained unchanged across Australia over the past decade and that figures for Indigenous births are twice those of non-Indigenous. Fetal autopsy is essential to determining possibly preventable causes of SB and the authors believe there is a need to identify both facilitators and barriers to obtaining consent for autopsy from Indigenous women and their families, in a culturally safe and appropriate manner, if progress is to be made in this area.
Submissions to ANZJOG in recent months have trended strongly towards obstetric topics rather than gynaecological, and this can be seen in this issue by the number of obstetric Original Manuscripts – ten plus three in the Indigenous health section, versus one gynaecological. Topics covered in the obstetric articles include thyroid dysfunction in pregnancy,7 outcomes for MCDA twins following laser therapy for twin-to-twin transfusion syndrome,8 the mixed and sometimes inaccurate information being given by professionals to the parents of extremely preterm babies9 and an interesting article on gestational surrogacy.10
Our one gynaecological Original Manuscript describes a case series of women with spontaneous regression of vulval intraepithelial neoplasia11 and a Short Communication looks at micronised progesterone for menopausal hormonal therapy.12 There is also a thoughtful review on a gynaecological topic: the controversy surrounding the use of dexamethasone for the prevention of female virilisation in congenital adrenal hyperplasia.13
I have also instituted a new section, Sexual and Reproductive Health, with the inaugural article describing variations in the post-abortion initiation of long-acting reversible contraception in a cohort of New Zealand women.14
The August issue of ANZJOG will include five articles on the subject of diabetes and pregnancy, a topic on which we are currently receiving a large number of submissions. We will also return to a more balanced number of a variety of gynaecological topics.