Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

Advanced Maternal Age and Autism Spectrum Disorder: Evidence from a Clinical Study in Sulaimania, Iraq

Document Type : Original Article

Authors
Mer M Omar 1
Daniel S Hamid 1
Van K Qadir 1
Hoya H Omar 2
1 Department of Psychiatry, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq.
2 Department of Psychiatry, College of Medicine, University of Sulaimani, Sulaimaniyah, Kurdistan Region, Iraq.
10.22038/psj.2025.91964.1499
Abstract
Introduction:
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition with multifactorial etiology. Advanced Maternal Age (AMA), defined as maternal age ≥35 years at childbirth, has been proposed as a potential risk factor for ASD. This study examined the association between AMA and ASD prevalence among children.
 Materials and Methods:
An observational, cross-sectional study was conducted among 177 mother–child dyads referred to the Committee for Diagnosing Mental Health at Shaheed Hemin Hospital in 2023. ASD diagnoses were established by a multidisciplinary committee consisting of psychiatrists, a pediatric neurologist, a psychologist, and a special education expert, following standardized clinical criteria. Maternal age was categorized as Adolescent (<20 years), Ideal (20–34 years), or Advanced (≥35 years). Associations between maternal age group and ASD diagnosis were evaluated using Chi-square tests.
Results:
A statistically significant association was found between maternal age group and ASD diagnosis. A higher proportion of ASD cases occurred among children born to mothers aged ≥35 years. Males represented 83% of diagnosed cases, yielding a male-to-female ratio of 4.9:1, which was also statistically significant. The mean maternal age at childbirth was 31.0 years, and the mean child age at presentation was 6.7 years. The most frequent age at diagnosis was 6 years.
Conclusion:
This study demonstrates a significant association between advanced maternal age and increased ASD risk within a clinical cohort from the Kurdistan Region-Iraq. These findings contribute region-specific epidemiological evidence and underscore the importance of incorporating maternal age considerations into early ASD screening and counseling protocols in comparable populations.
Keywords
Autism
autism spectrum disorder
advanced maternal age
children
Sulaimania
Subjects
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Journal of Patient Safety & Quality Improvement
Volume 14, Issue 1
Winter 2026
Pages 19-26