搜索结果：Revista medica de Chile

Weight stigma is a social determinant that negatively impacts the quality of medical care, particularly when it manifests in clinical decisions that prioritize body weight as the primary indicator of health. This practice, referred to as weight-centered care, can lead to inappropriate interventions and reinforce health inequities. To identify the personal and professional variables that predict a weight-centered approach in a simulated clinical case of low back pain, using a standardized vignette. Cross-sectional and correlational study with 79 medical residents in Chile. A validated clinical vignette was used along with scales assessing attributional beliefs and attitudes toward obesity treatment. A hierarchical multiple linear regression was conducted in four blocks, with bootstrap resampling (5,000 iterations) applied for robust estimations. The final model explained 52.5% of the variance in clinical weight-centeredness. Beliefs that individually blame patients for their obesity (β= 0.382; p*= 0.021) and negative attitudes toward its treatment (β= 0.276; p*= 0.087) were the most relevant predictors. Sociodemographic variables such as gender or BMI lost significance when these attitudinal factors were considered. No significant effects were found for professional variables. Findings show that internalized beliefs and attitudes about obesity are key to understanding weight-centered decision-making in clinical settings, even when weight is not relevant to the presenting complaint. This study provides local empirical evidence on an underexplored phenomenon in Chile and underscores the need to incorporate training frameworks that promote critical, non-stigmatizing, and person-centered care. Future research could explore educational interventions and the impact of weight-centered approaches on longitudinal clinical decisions.

Sudden cardiac death (SCD) is a rare and unexpected event that occurs in apparently healthy individuals. In Chile, only one report has evaluated its incidence, published ten years ago. To describe the incidence and etiology of SCD in Chile according to age, sex, and region, and to analyze its trend between 2010 and 2020. Descriptive ecological study using data from the Department of Health Statistics and Information. Mortality rates per 100,000 inhabitants and proportional mortality (% of total annual deaths) were calculated. Trends were assessed using Prais-Winsten regression (PW) with 95% confidence intervals (95% CI). A total of 1,115,620 deaths were recorded, of which 12,481 (1.12%) were attributed to SCD. The main causes were dilated cardiomyopathy (CMP) (37.15%), aortic dissection (17.24%), and complete atrioventricular block (9.63%). In individuals under 35 years of age, the most frequent etiologies were: dilated CMP (33.17%), hypertrophic CMP (16.17%), and aortic dissection (11.33%). Dilated CMP was the leading cause across both sexes and age groups. A decreasing trend was observed in both proportional mortality (PW: -0.038, 95% CI: -0.052; -0.025) and mortality rates in the total population (PW: -0.199, 95% CI: -0.261; -0.138). However, no significant decrease was observed in mortality rates in individuals under 35 years (PW: 0.003, 95% CI: -0.028; 0.034). The Valparaíso region recorded the highest rate (8.16/100,000), while Aysén had the lowest (2.80/100,000). SCD is infrequent in Chile. Its main causes are dilated cardiomyopathy and aortic dissection. While a decreasing trend is observed in the general population over the past decade, no such trend is seen in individuals under 35, highlighting the need for targeted prevention strategies.

The flipped classroom is a pedagogical model that fosters active learning by transferring theoretical content to a virtual environment. In medical education, this approach aims to enhance student engagement and promote the development of higher-order cognitive skills. While its implementation has demonstrated benefits, the existing evidence has predominantly focused on health sciences students in general rather than specifically on medical students, with most studies being non-experimental and published in English. To evaluate the impact of the flipped classroom compared to the traditional classroom model through a meta-analysis of randomized controlled trials. A comprehensive search was conducted across seven databases up to March 2025, in accordance with PRISMA guidelines. Randomized controlled trials comparing the flipped classroom to traditional teaching methods in medical students were included. The analysis was performed using RevMan 5.4 software, applying standardized mean differences (SMDs) within a random-effects model. A total of 40 studies met the inclusion criteria. The meta-analysis revealed that the flipped classroom significantly enhances theoretical knowledge (SMD= 0.99; 95% CI: 0.76-1.22) and practical skills (SMD= 1.34; 95% CI: 0.88-1.89) in medical students. However, no statistically significant difference was observed in student satisfaction (SMD= 0.54; 95% CI: -0.03-1.11). The flipped classroom model was associated with significant improvements in medical students' knowledge and practical skills; however, considerable heterogeneity was observed among the analyzed studies. No clear impact on student satisfaction was found.

The transgender population is growing and has specific health needs. Their desire for parenthood and their awareness of the adverse effects of gender-affirming hormone therapy is largely unknown. To determine the desire for parenthood and the knowledge about the effects of gender-affirming hormonal therapies on fertility among transgender individuals attending a national reference health center. Between 2019 and 2020, a representative survey was conducted with 100 transgender individuals at a nationally recognized transgender health center. The sample included 55 transfeminine individuals, 43 transmasculine individuals, and 2 non-binary individuals, with an average age of 29 years. Eighty-six had completed secondary education, and 90 were single. Sixty-nine percent were undergoing gender-affirming hormone therapy. Fifteen individuals had considered becoming parents; all of them reported not clearly understanding the effects of hormone treatment on their fertility. Only 4% had received information from health professionals regarding fertility options. Ten percent lived with children-three with biological children and seven with adopted children. Fifteen percent of the respondents expressed a desire for fertility but lacked clear information about the impact of hormone therapy on their reproductive capacity and options for fertility preservation. It is essential that healthcare professionals inform transgender individuals about their fertility possibilities and the effects of hormone therapy. Public policies related to fertility treatments for this population also need to be revised.

Staphylococcus aureus (S. aureus) persistently colonizes the nares of approximately 20-30% of healthy individuals, and the nasal carriage constitutes a risk of infection and transmission. This pathogen causes mild to severe infections, different strains show variable virulence, and methicillin-resistant S. aureus (MRSA) is a global concern. Due to the worldwide aging of the population, further research in older adults is necessary, such as the study of their microbiota. To determine the carriage of S. aureus in older adults in Valparaíso, Chile, and to characterize the phenotype and genotype of their isolates. In a transversal and descriptive study, S. aureus strains were isolated from nasal swabs of 223 older adults. Antimicrobial susceptibility was determined by agar diffusion technique. The virulence genes: Panton-Valentine leucocidine (pvl), methicillin-resistance (mecA), toxic shock syndrome toxin-1 (tst), and enterotoxin A (sea) were detected by polymerase chain reaction. Genotyping of two methicillin-sensitive S. aureus (MSSA) strains and one MRSA was performed using MiSeq-Illumina and bioinformatics analysis. We identified 41 S. aureus strains in 18.3% [95%CI: 13.5 - 24.1%] of individuals, and the percentage of S. aureus in men was greater than in women. MRSA was 1.3% [95%CI: 0.3-3.9%] without differences between sexes. The isolates showed high resistance to penicillin, followed by erythromycin, clindamycin, and gentamicin. Twenty-four percent of MSSA strains showed multidrug-resistance. Virulence genes sea (6+/41 strains), mecA (3+/41), pvl (2+/41), and tst (2+/41) were detected. Additionally, the genotypes: ST5-SCCmecI-1B), ST398, and ST45 were identified, showing different virulence. Nasal carriage of S. aureus was similar to studies of the general population and the same age group from Latin America and Europe; however, MRSA carriage was higher. Strains from older adults exhibited variable pathogenic potential and antimicrobial susceptibility, identifying the Chilean/Cordobes clone and MSSA strains corresponding to CC398 and CC45 previously described in healthy carriers.

Aortic stenosis is a common valvular heart disease, primarily associated with progressive sclerosis and calcification of the aortic valve. Its prevalence increases with age, and in the absence of effective pharmacological treatment, valve replacement remains the only therapeutic option in severe cases. In Chile, this condition is included in the Explicit Health Guarantees (GES) program as Health Problem No. 74, providing coverage for surgical interventions for chronic aortic valve disease. However, there is limited data on its healthcare burden and the actual implementation of the GES. To describe the demographic characteristics and temporal evolution of diagnoses and hospital discharges associated with GES No. 74. Hospital discharges recorded in the database of the Department of Health Statistics and Information (DEIS) between 2001 and 2023 were analyzed, along with GES records since its implementation in 2013. A total of 39,366 hospital discharges related to GES No. 74 diagnoses were identified between 2001 and 2023, showing a sustained increase over time. Of these, 54% corresponded to ICD-10 code I350: aortic stenosis, with the most frequent age group being 60-69 years (28.6%). Since 2013, 13,478 cases were reported under the public insurance system (FONASA) and 2,048 under private insurers (ISAPREs). Aortic stenosis is the main cause of intervention under GES No. 74, with a growing number of cases over time. It is essential to monitor effective access to these services and better characterize the beneficiary population to guide health policy planning.

Delirium is a geriatric syndrome and a frequent complication in hospitalized elderly people with cancer, whose occurrence is associated with increased morbidity and mortality in this particularly vulnerable population. To determine the frequency of delirium and associated risk factors in older adults with cancer hospitalized in a Chilean cancer center. Retrospective cohort study. Patients aged 75 years or older hospitalized at the Fundación Arturo López Pérez (FALP) over a 6-month period were included. Data were obtained by reviewing anonymized clinical records. A uni- and bivariate study was performed, as well as multiple logistic regression analysis. Retrospective cohort study. Patients aged 75 years or older hospitalized at the Fundación Arturo López Pérez (FALP) during a 6-month period were included. Data were obtained by reviewing anonymized medical records. A uni- and bi-variate study was performed, as well as a multiple logistic regression analysis. The frequency of delirium was 10.2%. The most significant risk factors were: emergency admission, patients at high risk of delirium, lack of previous geriatric evaluation and the presence of mood symptoms. This low frequency was obtained due to the correct implementation of the delirium preventive protocol in the oncology center.

Although robust screening protocols exist for the early detection of swallowing disorders, a detailed Clinical Swallow Examination (CSE) remains essential for guiding timely and effective intervention. The Mann Assessment of Swallowing Ability is a widely referenced tool, yet it omits several components critical to clinical practice. Following initial screening, Speech and Language Therapists (SLTs) often rely on non-standardized assessments developed locally. This lack of standardized tools with established psychometric properties hinders consistent clinical evaluation and the development of equitable treatment guidelines. To develop a standardized Spanish-language CSE focused on the non-nutritive component of oropharyngeal swallowing in adults, tailored for use by SLTs. The study was conducted in two phases. Phase 1 established content validity through expert consensus. Phase 2 evaluated psychometric properties, including internal consistency, inter-rater reliability, and construct and content validity. The instrument was tested with 132 participants (79 healthy individuals and 53 patients). Exploratory and confirmatory factor analyses initially supported the inclusion of 18 items. However, Cronbach's alpha indicated that three items-dentition, saliva accumulation, and odynophagia-did not significantly contribute to internal consistency. While two of these items were excluded, saliva accumulation was retained due to its positive contribution to model fit. The final version of the CSE included 16 items. Two scoring approaches were explored: a standardized, factor-derived score and a clinically oriented score based on the percentage of total item scores. Both performed similarly, although the clinically oriented score proved more practical for real-world application due to its ease of interpretation. This standardized CSE provides SLTs with a reliable and validated tool for assessing oropharyngeal dysphagia, especially in low- and middle-income countries with limited access to instrumental assessments. Its use supports more equitable, consistent, and effective patient care.

Ulcerative colitis and Crohn's disease are chronic conditions that can take a potentially severe or even life-threatening course, with high morbidity stemming from their complications. These diseases affect not only physical health but also significantly impact the quality of life of patients and their families. The primary goal of these guidelines is to provide treating physicians with clear, up-to-date information regarding the quality and strength of evidence supporting each therapeutic option. The document is intended to support shared clinical decision-making, empowering healthcare providers and patients to jointly develop a personalized treatment plan tailored to individual needs, preferences, and clinical characteristics. Although epidemio-logical data on inflammatory bowel disease (IBD) in Latin America remain limited, multiple studies have highlighted a substantial disease burden across the region, along with ongoing challenges in diagnosis, access to advanced therapies, and long-term management. In response to these needs -and recognizing the continuous advances in therapeutic strategies- the Chilean Working Group on Crohn's Disease and Ulcerative Colitis (ACTECCU) undertook the development of clinical guidelines aimed at the treatment of IBD in adult patients. The guideline was developed through a systematic review of the best available evidence, enriched by the active participation of a national panel of specialists who contributed their clinical expertise in the comprehensive management of IBD. Ultimately, these guidelines aim to optimize the management of IBD in Chile, promote more equitable access to evidence-based treatments, and improve health outcomes and quality of life for those living with these chronic conditions.

Hip fracture in older adults is a major public health issue due to its high frequency and associated mortality. In Chile, recent nationwide studies analyzing in-hospital mortality factors are scarce. To describe the characteristics of patients hospitalized for hip fracture in Chile between 2018 and 2022, and to identify factors associated with in-hospital mortality. We conducted a retrospective analytical study using national hospital discharge data from the Chilean Department of Statistics and Health Information (DEIS). We included patients with a primary diagnosis of hip fracture (ICD-10: S72.0, S72.1, S72.2). Descriptive and bivariate analyses were performed, followed by multivariable logistic regression to identify independent mortality risk factors. A total of 40,912 discharges were analyzed. The overall in-hospital mortality rate was 2.9%. Independent factors associated with higher mortality included: age ≥80 years (OR: 5.6; 95%CI: 3.7-8.7), male sex (OR: 1.3; 95%CI: 1.1-1.5), public health insurance (FONASA) (OR: 1.8; 95%CI: 1.2-2.6), no surgical treatment (OR: 6.3; 95%CI: 5.4-7.4), and longer hospital stay (OR per day: 1.02; 95%CI: 1.01-1.03). Falls were the main external cause (76.7%), most occurring at home. In-hospital mortality after hip fracture in Chile is significantly associated with older age, male sex, public insurance, lack of surgery, and prolonged hospital stay. These findings support the implementation of timely and equitable interventions to reduce mortality in this vulnerable population.

Cervical cancer (CC) is the fourth most common cancer in women worldwide and a major public health issue in Chile, where it ranks third in both incidence and mortality. Despite the national target of reaching 80% coverage of Papanicolaou (Pap smear) screening, previous studies suggest insufficient coverage with marked territorial disparities. To describe and analyze cervical cancer screening coverage through Pap smears in Chile between 2002 and 2023, identifying territorial differences and their relationship with socioeconomic indicators. We conducted an observational, longitudinal, and retrospective study using annual records from the National Municipal Information System and population projections from the National Institute of Statistics. Pap smear coverage was calculated per municipality, and temporal trends, geographic variations at municipal, provincial, and regional levels, and correlations with poverty and dependence on the Municipal Common Fund (MCF) were analyzed. A total of 6,616 records from 345 municipalities were analyzed. The national median coverage increased from 35.3% in 2002 to 51.1% in 2023, with no significant linear trend (R2= 0.14; p= 0.08). Only 2% of municipal records reached the 80% target. Wide territorial disparities were observed: Magallanes increased its coverage by 259%, while Atacama decreased by 42%. No region achieved the national goal. At the municipal level, coverage ranged from 0% to 98.5%. Correlations with poverty and MCF dependence were positive but weak, suggesting the influence of additional local factors. Despite increased Pap smear coverage, Chile has not yet met the proposed targets. Territorial disparities highlight the need for tailored interventions to improve screening coverage. Ensuring data quality and reliability is essential for informed public health decision-making, which is key to advancing toward the elimination of cervical cancer as a public health problem in Chile.

The teledermatology (TD) program of the public health sector in Chile has consolidated a reference model for the implementation of telemedicine systems in the public sector, transforming access to specialized care and optimizing the management of dermatological care demand. Since its early implementation, it has progressively integrated into the healthcare networks, complementing in-person care, delivering and educational component to general physicians and providing diagnostic and therapeutic support to the primary health care. To examine the evolution and consolidation of TD in Chile within the management of Hospital Digital project, highlighting its achievements and its impact on strengthening specialized public healthcare. A retrospective analysis of teleconsultations resolved on the Hospital Digital Teledermatology (TD) platform from January 2019 to February 2025. Among its achievements, the most notable are the reduction in waiting times and platform response times, improvements in the efficiency of the healthcare network's management and referal processes, the increase in resolution rates in primary health care, the optimization of referrals to secondary care, and the expansion of coverage to all regions of the country. These advances have been made possible by public investment in the development of information and communication technologies (ICT), the implementation of aligned health policies and objectives, and the establishment of an appropriate legislative framework that institutionalized the practice of TD in the country. Chile has been a pioneer in TD, using it not only as an access tool but also as a health management instrument. However, challenges persist, such as system interoperability, the integration of synchronous platforms, the refinement of the regulatory framework, and the incorporation of artificial intelligence for data analysis and processing.

In the current context of increasing production of biomedical studies, health professionals face significant challenges in remaining updated with the latest knowledge. Given this reality, literature reviews have emerged as vital tools to synthesize and organize existing knowledge in a coherent and accessible manner. Traditionally, narrative reviews have provided an initial approach to specific topics; however, these studies exhibit significant methodological limitations as they do not systematically describe the processes of identification, selection, and analysis of information. In contrast, systematic reviews adhere to explicit and rigorous methods that enable specific clinical questions to be answered with greater validity and reproducibility, thereby establishing a higher standard of evidence synthesis. The evidence synthesis ecosystem has experienced remarkable expansion in recent years, diversifying into multiple types of systematic reviews, each designed to address various research questions. The key to selecting the most suitable review lies in clearly defining the research question and the specific objective being pursued. The current trend indicates a shift from opinion studies -such as narrative reviews, which are primarily helpful for teaching clinicians and early career researchers- to systematically structured designs that address specific clinical questions and serve primarily for informed decision-making and the identification of research gaps. This article aims to provide key guidelines for selecting the most appropriate type of review according to the research question posed, as well as to describe the essential methodological aspects that should be considered during its development and reporting.

In clinical teaching within medical specialization programs, hierarchical relationships, institutional culture, and role modeling strongly influence professional training. Despite policies promoting Good Teaching Practices (GTP), barriers persist that hinder their effective implementation. To analyze coping strategies in response to perceived barriers to the institutionalization of GTP, based on testimonies from students and faculty of the Faculty of Medicine, University of Chile. A sociocritical qualitative study was conducted through group interviews with clinical teachers and students. A semi-structured guide, validated by experts and aligned with institutional policies, was applied. Thematic analysis involved initial semantic coding and inductive construction of categories. Ethical approval was obtained from the institutional committee. Two main categories emerged: (1) coping strategies at the individual (personal resilience), collective (support networks), and institutional (demand for clear regulations) levels; and (2) perceptions of GTP effectiveness, valued for their positive impact on the educational climate but constrained by organizational ambiguity and perceptions of symbolic measures. Students highlighted the gap between discourse and practice, whereas teachers emphasized the need for structural change. Both groups expressed willingness to transform the educational environment. Coping strategies illustrate individual and collective efforts to sustain good practices in adverse contexts, but their scope remains limited without sustained institutional commitment. Findings underscore the urgency of clear regulations, transparent processes, and active participation of students and teachers to advance toward a respectful and transformative teaching culture. This study provides evidence to inform institutional policies that strengthen specialized medical training.

Rheumatoid arthritis (RA) is a chronic disease that can affect the physical and psychosocial aspects of those who suffer from it. The coexistence of RA and mood disorders is recognized; however, there is no fully defined causal relationship. To relate the presence of depressive anxiety symptoms with disease activity and level of disability in patients with RA. Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaire (HAQ), Disease Activity Score-28 (DAS28), Clinical Disease Activity Index (CDAI) and Simplified Disease Activity (SDAI) were applied. Different statistical tests were used to determine the relationship between the variables. 122 patients with RA were studied and 46% (n= 56) presented symptoms of anxiety and/or depression. The mean DAS28 in patients without anxious and depressive symptoms was 2.75 and in patients with anxious and depressive symptoms was 4.33 (p <0.001). The mean SDAI in patients without anxious and depressive symptoms was 7.5 and in patients with anxious and/or depressive symptoms was 17 (p<0.001). The mean CDAI in patients without anxious and depressive symptoms was 7 and in patients with anxious and/or depressive symptoms was 15 (p<0.001). The mean HAQ in patients without anxious and depressive symptoms was 0.29 and the mean HAQ in patients with anxious and/or depressive symptoms was 1.18 (p< 0.001). About half of the patients with RA presented symptoms of depression and/or anxiety. Disease activity was significantly higher in patients with symptoms of depression and/ or anxiety, as was the level of disability measured by HAQ.

The global decline in birth rate, combined with increasing environmental noise, presents a significant public health challenge. The World Health Organization (WHO) has identified environmental noise as a risk factor for both maternal and neonatal health. In Chile, this trend mirrors global patterns, with rising levels of acoustic pollution and declining birth rates. To analyze the impact of environmental noise on low birth weight and prematurity in Chile during the period of 2018-2020. An ecological study was conducted analyzing secondary data on gestational health and environmental noise from the Metropolitan region, Valpara&#xed;so, and Biob&#xed;o in Chile. The birth rate, prevalence of low birth weight (LBW) and prematurity (PTL), and levels of daytime and nighttime environmental noise were quantitatively described. The attributable population risk was estimated using previously adjusted relative risks. The birth rate in Chile was 10.94 during the study period. An estimated 19,817 cases attributable to low birth weight and 3,055 premature births related to exposure to environmental noise during 2018-2020 were estimated. In Chile, daytime and nighttime environmental noise from vehicular traffic exceeded the dB levels established by the WHO international guidelines. This exposure represented a risk factor for the occurrence of low-birth-weight births, a condition that, along with the decrease in birth rate, poses an alarming public health problem, considering that low birth weight is one of the main causes of infant mortality in children under five years old worldwide.

To investigate sarcopenia in Chile, including its prevalence and association with sociodemographic and lifestyle factors. 232 participants from the Metropolitan Region, representing 1,037,790 older adults, were included in this cross-sectional analysis. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People 2019 statement. Age, sex, education, place of residency, marital status, smoking, self-perception of health, sleep, alcohol consumption, body mass index, waist circumference, physical activity, sedentary behaviour, and suspicion of cognitive impairment were the risk factors assessed. Poisson regression models were used to analyse the cross-sectional associations of sarcopenia by sociodemographic and lifestyle factors. All analyses accounted for the complex survey design and population expansion weights in Stata 18. 22.1% (95% CI: 15.5% to 30.3%) of the included participants exhibited sarcopenia. After adjusting, per each year of increment of age, the prevalence of sarcopenia increased by 4% (PR: 1.04 [95% CI: 1.01 to 1.08]). In addition, people with bad and regular self-reported health had 3.06 (95% CI: 1.34 to 6.98) and 1.88-times (95% CI: 1.03 to 3.41) higher prevalence of sarcopenia than people with a good perception. No other significant associations were identified. Considering that sarcopenia is associated with higher risk of disability and reduction in quality of life and it could begin early in life, actions to address its risk are more urgent than ever.

Hereditary transthyretin amyloidosis is an autosomal dominant disease caused by mutations in the TTR gene, which encodes the protein transthyretin. It is characterized by the deposit of mutated transthyretin in multiple organs and systems, mainly the heart and peripheral nervous system, causing different forms of polyneuropathy. It is a progressive, disabling and fatal disease. Early diagnosis of hereditary amyloidosis, including amyloidotic neuropathy, is currently relevant, as there are specific treatments that modify the natural course of the disease. The purpose of this consensus is to provide recommendations for Chile, based on scientific evidence, which facilitate the suspicion and early diagnosis of familial amyloidosis, focused on those patients who present with neuropathy as the initial manifestation, to facilitate the timely treatment of affected patients. A recommendation was developed by consensus through the Delphi method by eight Chilean neurologists specialized in neuromuscular diseases. The existing bibliographic evidence up to July 2024 was analysed. In patients with idiopathic sensory-motor axonal neuropathy, familial amyloidosis should be suspected if there are other family members who are also affected, if there is associated heart disease, dysautonomia, carpal tunnel syndrome, and/or multisystem involvement, in which early genetic screening is recommended. Demonstration of amyloid deposits in affected tissues and organs, such as nerves and heart, is recommended, although not mandatory, to establish a definitive diagnosis of the cause before prescribing specific treatment.

Over the past decade, Chile has experienced a sustained decline in birth rates, along with a progressive increase in maternal age at the time of first pregnancy. This phenomenon reflects demographic and sociocultural dynamics with significant implications for health planning and public policy. An ecological study was conducted using aggregated data from the National Institute of Statistics (INE) for the period 2010-2022. Trends in overall birth rates and age-specific fertility rates were described, as well as changes in the relative contribution of each maternal age group to the total number of births. The number of births in Chile declined by 24.5% between 2010 and 2022. Fertility among women aged 15 to 24 showed a marked decrease, while the proportion of births among women aged 30 and over increased steadily. A progressive shift in the reproductive timeline toward older maternal age groups was observed. Chile is undergoing an advanced stage of demographic transition, characterized by delayed motherhood. This shift is associated with higher levels of female education, unequal labor conditions, and structural barriers to balancing work and caregiving. Public policies must adapt to this new scenario through a life-course approach that promotes equity and shared responsibility, strengthening both the prevention of adolescent pregnancy and support for later motherhood.