{
  "abstract": "Objectives This study aimed to analyse temporal trends in fertility and birth rates, examine maternal characteristics and forecast future demographic changes in Georgia.Design This was a retrospective observational study using population-level data from the National Statistics Office of Georgia (Geostat) and the Georgian Birth Registry (GBR). Temporal trends were analysed using Prais-Winsten regression models and annual percentage changes (APCs) and future projections were generated using autoregressive integrated moving average (ARIMA) models.Participants The study included data on 543 662 live births retrieved from the Geostat for the period 2014–2024. Additionally, maternal characteristics were analysed for 366 684 births recorded in the GBR for the period 2017–2024. Selection criteria included all live births during the study period, with no specific exclusion criteria applied.Primary and secondary outcome measures Primary outcome measures were trends in the total fertility rate (TFR) and crude birth rate (CBR) over the study period (2014–2024) and their projections for 2025–2034. Secondary outcome measures were concurrent changes in maternal characteristics, including maternal age, nationality, place of residence, region of residence and parity.Results Between 2014 and 2024, Georgia’s TFR declined from 2.30 to 1.68 children per woman (APC=3.12%, 95% CI −3.65 to −2.59), and the CBR dropped from 16.3 to 10.7 births per 1000 population per year (APC=4.39%, 95% CI −4.63 to −4.15). Fertility rates decreased most significantly among women aged <20 (APC=−9.93%, 95% CI −10.72 to −9.13) and 20–24 years (APC=−6.41%, 95% CI −7.70 to −5.10). Advanced maternal age increased in both nulliparous (APC=3.65%, 95% CI 1.83 to 5.51) and multiparous women (APC=1.67%, 95% CI 1.12 to 2.22). ARIMA forecast based on current trends showed a continued decline in the TFR to 1.09 (95% CI 0.91 to 1.27) children per woman and the CBR to 7.07 (95% CI 5.97 to 8.16) births per 1000 population by 2034.Conclusions Georgia is undergoing a demographic transition characterised by declining fertility rates and delayed childbearing. Assuming the mechanisms underlying 2014–2024 data remain unchanged, projections indicate a continued decline in fertility and birth rates by 2034, which may pose significant social and economic challenges for the country. Further research is needed to explore the underlying factors driving these trends and to develop strategies to address the potential implications of this demographic shift.",
  "authors": [
    {
      "affiliations": [
        "Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway",
        "Department of Medical Statistics, National Centre for Disease Control and Public Health, Tbilisi, Georgia"
      ],
      "name": "Nia Khachidze"
    },
    {
      "affiliations": [
        "Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway"
      ],
      "name": "Erik Eik Anda"
    },
    {
      "affiliations": [
        "Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway"
      ],
      "name": "Tinatin Manjavidze"
    },
    {
      "affiliations": [
        "Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway"
      ],
      "name": "Ingvild Hersoug Nedberg"
    },
    {
      "affiliations": [
        "Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway",
        "Bergen Centre for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway"
      ],
      "name": "Ingvild Fossgard Sandøy"
    },
    {
      "affiliations": [
        "Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway"
      ],
      "name": "Charlotta Rylander"
    }
  ],
  "title": "Temporal trends and future projections of fertility and birth rates in Georgia: a retrospective observational study",
  "uid": "b30b7430-f428-5597-8bbc-a17ea3ff6e61"
}