Gender Disparity in Authorship of Critical Care Scientific Publications From Low-, Middle-, and High-Income Countries

OBJECTIVES: To investigate whether gender disparity in authorship of critical care scientific publications is greater in studies originating from low- and middle-income countries (L/MICs) compared with those from high-income countries (HICs). DESIGN: Cross-sectional bibliometric analysis. SETTING: Original research publications, including observational studies and randomized controlled trials, published from 2018 to 2022 in the ten critical care journals with the highest 2022 impact factors as reported by Clarivate Analytics Journal Citation Reports. PATIENTS: A total of 4,982 publications, 4,479 from HICs, and 503 from L/MICs, comprising 50,357 authors. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the proportion of women authors overall, and in first and senior positions; proportions of coauthors; differences by country income classification; temporal trends; and subgroup analyses stratified by funding type. Women accounted for 31.3% of all authors, 35.4% of first authors, and 21.4% of senior authors. Women's representation was higher in L/MICs than in HICs (38.2% vs. 30.6%; p < 0.01). The proportion of women in first (40.7% vs. 34.7%; p < 0.01) and senior (27.6% vs. 20.7%; p < 0.01) positions was also higher in publications from L/MICs. Coauthorships (i.e., the dyad of first and senior authors) involving at least one woman accounted for less than 30% across all publications. There were temporal increases in overall and senior woman authorship in HICs (p < 0.01 for both) and in overall authorship in L/MICs (p = 0.02). Women authors were more frequently represented among funded publications from L/MICs. CONCLUSIONS: Among high-impact critical care journals, substantial gender disparities persisted in authorship of publications. Women are better represented in publications from L/MICs, and there was an increase in women's authorship over time in both HICs and L/MICs from 2018 to 2022.