Late Motherhood and the Rising Risk of Autism

With an increasing number of women choosing to conceive later in life, studies indicate a significant link between advanced maternal age and a higher risk of autism in children.

Aarti’s life changed at 40 when her three year old son was diagnosed with autism. She had a hard time deciphering the reason behind his disdain for eye contact, his absence of response when called by his name, and his anxiety over loud noises. As a single mother, she had to navigate medical appointments, therapy sessions, and societal pressure. She soon realized she was not alone. Many women, due to various personal and professional reasons, are conceiving in their late 30s and 40s, a trend that medical experts warn is linked to an increased risk of autism.

 Understanding Autism

Autism, a complex neurological condition affecting social interaction, communication, and behavior, is rising globally. In India, ICMR estimates it affects 1 in 100 children, though underreporting may mask higher numbers. Autism varies widely, with some facing speech and sensory challenges while others excel in specific areas. While its causes remain unclear, early intervention and awareness can help autistic individuals thrive in an inclusive society.

Recent studies have pointed to a strong correlation between advanced maternal age and a higher likelihood of autism diagnoses. Dr Praveen Gupta, Principal Director & Chief of Neurology, Fortis Hospital elaborates, “Women who conceive after 35 are more prone to chromosomal abnormalities, genetic mutations, and hormonal imbalances, all of which can contribute to neuro developmental disorders in children. Aging eggs have a greater chance of carrying genetic variations that may increase the risk of autism.”

Medical research has also linked late pregnancies with complications such as gestational diabetes, high blood pressure, preterm birth, and fetal distress, all of which can impact brain development in the womb.

A comprehensive meta-analysis published in BMC Psychology (Nov 2024) found that children born to older mothers had a 44% increased risk of developing autism compared to those born to younger mothers. The analysis also revealed that a 5-year increase in maternal age corresponded to a 22% rise in autism risk

Another study published in The British Journal of Psychiatry supported these findings, indicating that maternal age over 30 was associated with an increased risk of autism. Specifically, for mothers aged 30–34 compared to those aged 25–29, there was a 27% increased risk, and for mothers aged 40 and above compared to those under 30, the risk more than doubled.

While maternal age is a crucial factor, doctors caution that it is not the sole cause of autism Dr Tejas Hambir, Consultant – Paediatrics and Neonatal Intensivist, Jupiter Hospital points out, “We are seeing a rising number of autism cases across different maternal age groups. Though late pregnancies do carry a higher risk. Environmental factors, genetic predisposition, and even paternal age above 40 have also been linked to ASD. Besides, the rising awareness about Autism is also linked to more reporting of cases.”

“Additionally, pollution, exposure to heavy metals, and lifestyle choices such as unhealthy diets, stress, and lack of prenatal care are also being studied as potential contributors to the increasing prevalence of autism,” he added.

According to experts, Autism is often misunderstood, leading to social stigma that isolates both children and their parents.

“Many families face judgment, lack of acceptance, and misinformation, making it harder to seek support. The emotional toll on parents can be immense, with feelings of guilt, anxiety, and exhaustion as they navigate their child’s needs while confronting societal prejudice. Parents not only battle the condition itself but also the ignorance and stigma that come with it,” Dr. Taruna Dua, Senior Consultant & Unit Head – Unit 1, Obstetrics & Gynaecology, Aakash Healthcare.

Despite the risks, many women still choose to conceive later due to career priorities, financial stability, or personal circumstances. Doctors recommend a proactive approach for those planning pregnancies in their late 30s or 40s.

Dr. Amrita Razdan Kaul, Obstetrics & Gynaecology, Asian Hospital suggests, “Women who are planning to conceive at an older age should undergo thorough preconception counseling. Regular check-ups, proper prenatal screening, maintaining a healthy lifestyle, and reducing stress levels can help improve pregnancy outcomes.”

She also stresses the importance of genetic counseling for older mothers, which can help assess potential risks and prepare for any complications.

 Early Diagnosis and Intervention

While the causes of autism are complex, one undeniable fact remains—early diagnosis and intervention can significantly improve outcomes for children with ASD. Experts urge parents, regardless of their child’s age, to seek help if they notice signs such as:

•Delayed speech and language skills

•Avoidance of eye contact

•Repetitive behaviors (hand flapping, rocking, spinning objects)

•Preference to solitary activities or have difficulty engaging in reciprocal interactions.

“Early interventions such as speech therapy, occupational therapy, and special education,  can help children with autism, develop better communication and coping skills, allowing them to lead more independent lives”, added Dr. Taruna Dua.