Characteristics of Fetal Deaths due to Congenital Anomalies in Korea and Annual Trends from 2009–2020: A Retrospective Study in Korea

Objective: Research on fetal mortality due to congenital anomalies is insufficient, particularly that utilizing data specific to South Korea.Thus, we aimed to investigate the characteristics and risk factors for fetal death due to congenital anomalies in Korea.Methods: Fetal deaths registered from 2009-2020 with Statistics Korea were assessed.Fetal characteristics included gestational age, body weight, sex, and multiple fetuses, while maternal characteristics included age, educational level, nationality, and place of residence.Risk factors for fetal death were analyzed using simple comparison and logistic regression.Changes in fetal mortality by year were examined using Poisson regression analysis.Results: A total of 37,928 fetal deaths occurred, among which 3,758 were classified as congenital anomaly, 710 as non-congenital anomaly, and 33,460 as unknown cause.Fetal mortality for gestational weeks 20 to 27 and ≥28 were 75.3% and 24.7%, respectively.The proportion of congenital anomalies among fetal deaths during these gestational age periods is 11.3% and 5.8%.Multiple fetuses, maternal age of <20 years or ≥40 years were identified as risk factors for fetal death due to congenital anomalies.Among the top 30 causes, covering 97.5% of all deaths, unspecified causes were 88.2%, congenital malformations 8.2%, and other causes 2.0%, respectively.Fetal mortality and deaths from congenital anomalies exhibited downward trends.Conclusion: Fetal deaths due to congenital anomalies showed a decreasing trend, but the risks, such as multiple fetuses and advanced maternal age are increasing in Korea.Therefore, careful monitoring of fetal deaths due to congenital anomalies are essential.