Child disability in Spain: maternal age as main correlate of etiology, severity and extension

While child disability is not a rare phenomenon in Spain (2-3%), population-level knowledge on this topic is surprisingly scarce. Most public health studies focus on adult disability and are based on regional-level or small-size cohort data. Using nationally representative data, this study assesses whether general patterns in etiology, severity and extension of child disability correlate with maternal sociodemographic characteristics (age at birth, education, and migrant origin). As these are important for obstetric outcomes and perinatal health, they may also underlie variations in the etiology and nature of child disability. The study draws on the Spanish Survey on Disability, Personal Autonomy and Dependency Situations 2020. It includes individuals with disability aged 2 to 15 years (initial n = 296). Using descriptives and regression analyses it examines patterns in the etiology of disability (congenital vs acquired), its severity (severe vs moderate), and extension (developmental areas affected) and their association with maternal age, education and migrant background. The most evident sociodemographic correlate of the characteristics of child disability is maternal age, consistently associated as it rises with a higher probability of severity and greater extension; particularly after age 40. The likelihood of acquired disability is higher for children born to 40+ mothers. Those born to mothers of migrant origin could be more prone to severe disability, yet this association is not statistically significant. Advanced maternal age is thus not only a risk factor for adverse perinatal outcomes, but also for more severe and extensive disability when it occurs. These findings underscore the importance of intensive surveillance during pregnancy, childbirth and early childhood for this population segment and other potentially vulnerable groups, and of policies that facilitate childbearing at earlier ages.

Key messages

• Advanced maternal age is not only associated with a higher risk of adverse perinatal events, but also with greater severity and extension of child disability when it occurs.

• Intensive surveillance during pregnancy, childbirth and early childhood when mothers are of advanced maternal age could improve child disability outcomes.