Academic Journal
The estimated potential birth loss from female accidental mortality in Iran, 2011-2023.
| Title: | The estimated potential birth loss from female accidental mortality in Iran, 2011-2023. |
|---|---|
| Authors: | Eshraghi R; Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Eshraghi.rza@gmail.com.; Social Determinants of Health Research Center Daneshgah Bvld, Isfahan, Iran. Eshraghi.rza@gmail.com., Amini-Rarani M; Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.; Iranian Research Network for Social Determinants of Health (IRNSDH), Tehran, Iran., Motlagh ME; School of Medicine, Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran., Rahimi A; Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.; Clinical Informationist Research Group, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran., Mohseni M; Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran., Bahrami A; Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran., Amini M; School of Medicine, Kashan University of Medical Sciences, Isfahan, Iran., Mousavi N; School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Galehdari H; Secretariat of Health and Food Security, Isfahan University of Medical Sciences, Isfahan, Iran., Bashzar S; Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. sbashzar03@gmail.com. |
| Source: | Population health metrics [Popul Health Metr] 2026 Jul 09; Vol. 24 (1). Date of Electronic Publication: 2026 Jul 09. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 101178411 Publication Model: Electronic Cited Medium: Internet ISSN: 1478-7954 (Electronic) Linking ISSN: 14787954 NLM ISO Abbreviation: Popul Health Metr Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2003]- |
| MeSH Terms: | Accidents, Traffic*/mortality , Birth Rate*/trends , Accidental Injuries*/mortality, Iran/epidemiology ; Female ; Humans ; Retrospective Studies ; Adult ; Adolescent ; Middle Aged ; Young Adult ; Fertility |
| Abstract: | Background: Road-traffic injuries remain an important cause of premature death among women of reproductive age in Iran. We quantified the number of potential births not realised that are attributable to female deaths from road-related accidents, to inform injury-prevention and fertility policy. Methods: We conducted a retrospective, population-based counterfactual analysis for 2011-2023. Annual female deaths from road-traffic injuries by age (Global Burden of Disease 2023) were regarded "aged forward" to identify women who would have been 15-49 years in a given year had they survived. For each age-year cell, we multiplied the resulting count of "missing" women by the contemporaneous age-specific fertility rate (ASFR) from national sources, and summed across ages to estimate potential births not realised each year. Uncertainty was propagated using a deterministic bound approach based on lower/upper bounds of mortality and fertility inputs. Results: Female accidental mortality was associated with an estimated 121 929 (cumulative) potential births not realized from 2011 to 2023. Annual losses declined by 55%, from 12 889 (conservative uncertainty bounds 4 053-24 936) in 2011 to 5 829 (conservative uncertainty bounds 3 200-7 685) in 2023, indicating a significant downward trend. Although small relative to Iran's multi-decade decline in overall births, these counterfactual losses persist at non-trivial levels. Conclusion: Further reductions in preventable road-traffic deaths among women of reproductive age could modestly increase realised births while delivering primary health gains. Priorities include safer speeds and infrastructure, seat-belts/helmets, safer vehicles, fair enforcement, and strengthened prehospital and trauma care, measures that complement existing fertility initiatives without coercion. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Ethics approval and consent to participate: This study was approved by the Research Ethics Committee of the School of Nursing, Rehabilitation, and Management, Isfahan University of Medical Sciences, Isfahan, Iran (approval code: IR.MUI.NURENA.REC.1404.060; scientific code: 240453). All methods were carried out in accordance with relevant guidelines and regulations and with the principles of the Declaration of Helsinki. The study used only aggregated, de-identified secondary data (Global Burden of Disease mortality estimates and nationally reported age-specific fertility rates). No individual human participants were contacted or enrolled, and the requirement for informed consent was formally waived by the Ethics Committee. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests. |
| References: | Mehrolhassani MH, Mirzaei S, Poorhoseini SS, Oroomiei N. Finding the reasons of decrease in the rate of population growth in Iran using causal layered analysis (CLA) method. Med J Islamic Repub Iran. 2019;33:92. Mohamadi E, Taheri M, Yazdanpanah M, Barakati SH, Salehi F, Akbari N, Khosravi A, Eini-Zinab H, Ghafoori F, Rahimi A. Identification of Indicators for Reproductive Health and Population Programs Monitoring in Iran. J Midwifery Reproductive Health 2023, 11. Polizzi A, Tilstra AM. The impact of early death on birth counts in the United States, 1950 to 2019. PNAS Nexus. 2024;3:pgae058. (PMID: 10.1093/pnasnexus/pgae0583885491111157966) Shahbazi F, Nazari SSH, Soori H, Khodakarim S. Socioeconomic inequality in mortality from road traffic accident in Iran. J Res health Sci. 2019;19:e00437. (PMID: 311336316941628) Abbasi A, Balafar M, Pouraghaei M, Golzari SE, Soleimanpour M, Ahmadi S, Soleimanpour H. The national and provincial burden of transport injuries in Iran between 1990 and 2021. Sci Rep. 2025;15:10007. (PMID: 10.1038/s41598-025-94995-y4012294811930925) Heydari M, Yarifard K, Tajvar M. The trend of death rate and causes of death based on the ICD-10 among young people in Iran within the last three decades. Iran J public health. 2024;53:472. (PMID: 3889483411182481) Sun J, Collaborators GD. Global age-sex-specific all-cause mortality and life expectancy estimates for 204 countries and territories and 660 subnational locations, 1950–2023: A demographic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406:1731–810. (PMID: 10.1016/S0140-6736(25)01330-3) Gu D, Ou S, Liu G. Global burden of road injuries and their attributable risk factors from 1990 to 2021: A systematic analysis for the global burden of disease study 2021. Prev Med Rep. 2025;53:103051. (PMID: 10.1016/j.pmedr.2025.1030514023557711997400) Murray CJ, Callender CS, Kulikoff XR, Srinivasan V, Abate D, Abate KH, Abay SM, Abbasi N, Abbastabar H, Abdela J. Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1995–2051. (PMID: 10.1016/S0140-6736(18)32278-5) TUMS. Total Fertility Rate in I.R.Iran. Comprehensive Report. National Institute of Health Research; 2019. Elham Fathi JN, Nasiripour M. The fertility trend in Iran from 2017–2021. National Statistical Centre of Iran; 2021. Shen T, Lazzari E, Canudas-Romo V. The contribution of survival to changes in the net reproduction rate. Popul Stud. 2023;77:163–78. (PMID: 10.1080/00324728.2023.2187441) Sarma R, Hussain N, Choudhury L. India’s Demographic Aspects from the Perspective of Dynamic Net Reproduction Rate. Can Stud Popul. 2023;50:6. (PMID: 10.1007/s42650-023-00077-7) World Health O. Iran (Islamic Republic of) — Country Overview. 2025. Ahmed SAA, Ibrahim RE, Younis EM, Abdelwarith AA, Faroh KY, El Gamal SA, Badr S, Khamis T, Mansour AT, Davies SJ, ElHady M. Antagonistic Effect of Zinc Oxide Nanoparticles Dietary Supplementation Against Chronic Copper Waterborne Exposure on Growth, Behavioral, Biochemical, and Gene Expression Alterations of African Catfish, Clarias gariepinus (Burchell, 1822). Biol Trace Elem Res. 2024;202:5697–713. (PMID: 10.1007/s12011-024-04115-638416342) Eksler V, Lassarre S, Thomas I. Regional analysis of road mortality in Europe. Public Health. 2008;122:826–37. (PMID: 10.1016/j.puhe.2007.10.00318620716) Lozano M, Esteve A, Boertien D, Mogi R, Cui Q. Lowest low fertility in Spain. Demographic Res. 2024;51:625–36. (PMID: 10.4054/DemRes.2024.51.19) Spoerri A, Egger M, von Elm E. Mortality from road traffic accidents in Switzerland: longitudinal and spatial analyses. Accid Anal Prev. 2011;43:40–8. (PMID: 10.1016/j.aap.2010.06.00921094295) Ranjbar M, Shafaghat T, Lotfi MH, Alimondegari M, Kalantari F, Bazyar M. What family policies do Iranian couples prefer for childbearing? Evidence from a discrete choice experiment. BMC Public Health. 2025;25:821. (PMID: 10.1186/s12889-025-21938-74002204811871701) Nejhaddadgar N, Mardi A, Zare M. The impact of new population policies on women’s reproductive health pattern in Ardabil, Iran: a comparative cross-sectional study. Front Reproductive Health. 2025;7:1520027. (PMID: 10.3389/frph.2025.1520027) |
| Contributed Indexing: | Keywords: Accidental deaths; Female mortality; Fertility impact; Injury prevention; Potential birth lost; Reproductive age |
| Entry Date(s): | Date Created: 20260710 Date Completed: 20260714 Latest Revision: 20260726 |
| Update Code: | 20260726 |
| PubMed Central ID: | PMC13366958 |
| DOI: | 10.1186/s12963-026-00499-w |
| PMID: | 42426833 |
| Database: | MEDLINE |
| ISSN: | 1478-7954 |
|---|---|
| DOI: | 10.1186/s12963-026-00499-w |