Estimated Autism Risk and Older Reproductive Age

Objectives. We sought to estimate the risk for autism associated with maternal and paternal age across successive birth cohorts. Methods. We linked birth records and autism diagnostic records from the California Department of Developmental Services for children born in California between 1992 and 2000 to calculate the risk associated with maternal and paternal age for each birth cohort as well as for the pooled data. Results. The categorical risks associated with maternal age over 40 years ranged from a high of 1.84 (95% confidence interval [CI]=1.37, 2.47) to a low of 1.27 (95% CI=0.95, 1.69). The risk associated with paternal age ranged from 1.29 (95% CI=1.03, 1.6) to 1.71 (95% CI=1.41, 2.08). Conclusions. Pooling data across multiple birth cohorts inflates the risk associated with paternal age. Analyses that do not suffer from problems produced by pooling across birth cohorts demonstrated that advanced maternal age, rather than paternal age, may pose greater risk. Future research examining parental age as a risk factor must be careful to avoid the paradoxes that can arise from pooling data, particularly during periods of social demographic change. (Am J Public Health. 2009;99:1673-1679. doi:10.2105/AJPH.2008.149021)