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Background: The main barrier for an appropriate primary management of the reproductive health was lack of knowledge about the risk factors and prevention measures for infertility and the main recommendations was to involve primary care physicians in reproductive health., Aims: To reach a consensus around barriers and enablers for appropriate primary management of the reproductive health., Methods: An observational study was performed using the modified Delphi technique, from October 2017 to April 2018 in private and public assisted reproduction clinics in Spain. A questionnaire consisted of 58 items, divided into four blocks to explore consensus among a group of experts by synthesizing opinions., Results: In the first Delphi round, the response rate was 50% and panelists reached a 72.4% of consensus. In second round, the response rate was 55% and panelists reached a 25% of consensus. To minimize limitations related to the use of a structured questionnaire, a space for free text responses was provided. The following items yielded unanimous agreement: "It is necessary to promote reproductive planning-not just contraception-from secondary school," "The media should not trivialize pregnancies in women aged over 50," "Postponing family formation is the main cause of the increase in assisted reproduction treatments in Spain," and "Postponing motherhood implies an inherently decreased probability of having children.", Conclusions: These recommendations could set the basis for a public health action plan for primary management of reproductive health. The findings may be applicable to any country whose health services system provides primary healthcare.

Background: Randomised clinical trials are considered to be the most reliable study design for assessing the efficacy and safety of health interventions., Aims: To analyse worldwide obstetrics research carried out through randomised clinical trials, from 2002 to 2013., Methods: A bibliometric analysis was performed. Publications on obstetrics that were published journals indexed in the MEDLINE database from 2002 to 2013 were analysed. The major medical subject headings used in the search were obstetrics, pregnancy complications and obstetrics surgical procedures. The main study outcome was index of research productivity., Results: Our study search strategy yielded a total of 142,659 articles and 9967 clinical trials. The growth rate of scientific production in obstetrics during this period was 55.43% (n = 5094). The growth rate of production of randomised clinical trials in this specialty, meanwhile, was 97.84% (n = 544). Most of the identified authors (n = 22,622, 71.21%) published only one paper during the study period. Patterns of co-authorship among the 20 most productive authors were identified. After applying Bradford's law, six journals in the nucleus (the most prolific journals) were found. Of all the clinical trials in obstetrics published between 2002 and 2013, 10.3% were published in journals belonging to categories other than Obstetrics and Gynecology. The most common research topic in 2002 and 2013 was the use of analgesia and anesthesia in obstetrics., Conclusions: Total scientific production rate in obstetrics increased from 2002 to 2013, especially randomised clinical trials. However, randomised clinical trials continue to represent a small proportion of total production.