Global misalignment of postpartum hemorrhage research output and corresponding-author leadership indicators with maternal-hemorrhage burden: a scientometric analysis, 2000-2025

Introduction Bibliometric indicators are widely used to describe scientific activity, but publication counts alone do not show whether research output and corresponding-author leadership indicators are aligned with population health needs. We examined this question for postpartum hemorrhage (PPH), a major cause of preventable maternal mortality. Methods We analysed 7,238 articles and reviews indexed in the Web of Science Core Collection from 2000 to 2025 and linked country-level PPH research participation and corresponding-author leadership indicators to Global Burden of Disease 2023 estimates of maternal-hemorrhage disability-adjusted life years (DALYs), used as the closest available global proxy for PPH-relevant hemorrhage burden. Fractional counting was used to avoid inflating national credit in multinational publications, and research-burden ratios were calculated to compare each country's publication share with its burden share. Results Maternal-hemorrhage DALYs were positively but weakly associated with fractional PPH research participation (Spearman rho = 0.348, p < 0.001) and more weakly associated with corresponding-author leadership indicators (rho = 0.201, p = 0.004). The 51 countries in the highest burden quartile accounted for 96.4% of global DALYs but only 23.3% of fractional PPH research participation and 21.9% of corresponding-author leadership indicators. Low- and lower-middle-income countries carried 91.5% of DALYs but accounted for 10.5% of research participation and 8.9% of corresponding-author leadership indicators. Discussion These findings show a large research-burden mismatch and a parallel mismatch in corresponding-author leadership indicators in the PPH literature, illustrating how burden-adjusted scientometric indicators can inform research assessment, priority setting, and equitable collaboration.