Background: Delayed motherhood -- defined as first childbirth at or after age 30 -- is a growing demographic phenomenon across sub-Saharan and North Africa, driven by intersecting socioeconomic forces including educational attainment, urbanization, economic precarity, and shifting gender norms. Objective: This study aimed to quantify the prevalence and socioeconomic drivers of delayed motherhood across African regions and to assess its association with maternal and neonatal medical outcomes. Methods: A cross-sectional analytical design was employed using simulated nationally representative data (n=1,240) drawn from five African regions. Univariate descriptive statistics characterized sample distributions; chi-square tests and ANOVA evaluated bivariate associations between maternal age groups and health outcomes; and Structural Equation Modelling (SEM) elucidated latent pathways linking socioeconomic determinants to delayed motherhood and subsequently to medical risks. Binary logistic regression identified independent predictors of composite adverse maternal outcomes. Results: The mean age at first birth was 28.7 years (SD=5.82), with 39.4% of women classified as delayed mothers. Bivariate analyses revealed statistically significant gradients across all seven medical outcomes by age group (all p