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 charac teristics included gestational age, body weight, sex, and multiple fetuses, while maternal characteri stics 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 gesta tional 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.

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 charac teristics included gestational age, body weight, sex, and multiple fetuses, while maternal characteri stics 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 gesta tional 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.

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 charac teristics included gestational age, body weight, sex, and multiple fetuses, while maternal characteri stics 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 gesta tional 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.

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 charac teristics included gestational age, body weight, sex, and multiple fetuses, while maternal characteri stics 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 gesta tional 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.

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 charac teristics included gestational age, body weight, sex, and multiple fetuses, while maternal characteri stics 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 gesta tional 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.

Purpose: Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA2DS2-VASc score of 0–1, are still at risk of stroke. This study verified the usefulness of ABCD score [age (≥60 years), B-type natriuretic peptide (BNP) or N-terminal pro-BNP (≥300 pg/mL), creatinine clearance (<50 mL/min/1.73 m2 ), and dimension of the left atrium (≥45 mm)] for stroke risk stratification in non-gender CHA2DS2-VASc score 0–1. Materials and Methods: This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA2DS2-VASc score 0–1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated. Results: Overall, 2694 patients [56.3±9.5 years; female, 726 (26.9%)] were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100 P-Y for an ABCD score of 0; 1.02/100 P-Y for an ABCD score ≥1. The ABCD score was superior to non-gender CHA2DS2-VASc score in the stroke risk stratification (C-index=0.618, p=0.015; net reclassification improvement=0.576, p=0.040; integrated differential improvement=0.033, p=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score ≥1 than in those without ATT (0.44/100 P–Y vs. 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11–0.63, p=0.003). Conclusion The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA2DS2-VASc score 0–1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA2DS2-VASc score 0–1.

Atrial fibrillation (AF) is the most common arrhythmia which needs management for stroke prevention. Therefore, it has emphasized the importance of screening for general population to detect AF earlier. We conducted screening for AF in the Chonbuk region in South Korea. Participants who were older than 50 years were enrolled. The screening test used a single lead electrocardiography (ECG) (KardiaBand, AliveCor, CA, USA). Diagnosis of AF was confirmed by electrophysiologists, if the single lead ECG demonstrated AF of more than 30 seconds. We analyzed the prevalence of AF and the characteristics of newly detected AF patients. A total of 2728 participants, 145 (5.3%) participants had already been diagnosed with AF before. The number of screening positive was 55. Among them, 40 participants were confirmed for AF. Male gender and age older than 70 years were the independent risk factors for AF among the screening positive participants. Most of newly detected AF patients were at high risk for stroke which had more than 2 points on the CHA2DS2-VASc score. We followed up with those patients and encouraged them to visit the hospital. As a result, 31 (77.5%) patients started to manage AF. The additional 1.2% of AF was detected by a screening test with a single lead ECG monitor device. Considering most participants of newly detected AF by screening were at high risk for stroke, it was thought that AF was still undertreated. Therefore, screening tests with simple mobile device might be useful for early detection of AF.

Atrial fibrillation (AF) is the most common arrhythmia which needs management for stroke prevention. Therefore, it has emphasized the importance of screening for general population to detect AF earlier. We conducted screening for AF in the Chonbuk region in South Korea. Participants who were older than 50 years were enrolled. The screening test used a single lead electrocardiography (ECG) (KardiaBand, AliveCor, CA, USA). Diagnosis of AF was confirmed by electrophysiologists, if the single lead ECG demonstrated AF of more than 30 seconds. We analyzed the prevalence of AF and the characteristics of newly detected AF patients. A total of 2728 participants, 145 (5.3%) participants had already been diagnosed with AF before. The number of screening positive was 55. Among them, 40 participants were confirmed for AF. Male gender and age older than 70 years were the independent risk factors for AF among the screening positive participants. Most of newly detected AF patients were at high risk for stroke which had more than 2 points on the CHA2DS2-VASc score. We followed up with those patients and encouraged them to visit the hospital. As a result, 31 (77.5%) patients started to manage AF. The additional 1.2% of AF was detected by a screening test with a single lead ECG monitor device. Considering most participants of newly detected AF by screening were at high risk for stroke, it was thought that AF was still undertreated. Therefore, screening tests with simple mobile device might be useful for early detection of AF.

Activated phosphoinositide 3-kinase δ syndrome (APDS)1 is caused by gain-of-function mutations in PIK3CD, which encodes the catalytic p110δ subunit of phosphoinositide 3 kinase. We describe three patients with APDS1, the first thereof in Korea. Therein, we investigated clinical manifestations of APDS1 and collected data on the efficacy and safety profile of sirolimus, a mammalian target of rapamycin inhibitor and pathway-specific targeted medicine. The same heterozygous PIK3CD mutation was detected in all three patients (E1021K). After genetic diagnosis, all patients received sirolimus and experienced an excellent response, including amelioration of lymphoproliferation and improvement of nodular mucosal lymphoid hyperplasia in the gastrointestinal tract. The median trough level of sirolimus was 5.5 ng/mL (range, 2.8–7.5) at a dose of 2.6–3.6 mg/m2. Two patients who needed highdose, short-interval, immunoglobulin-replacement treatment (IGRT) had a reduced requirement for IGRT after initiating sirolimus, and the dosing interval was extended from 2 and 3 weeks to 4 weeks. The IgG trough level after sirolimus treatment (median, 594 mg/dL; range, 332–799 mg/dL) was significantly higher than that before sirolimus treatment (median, 290 mg/dL; range, 163–346 mg/dL) (p<0.001). One episode of elevated serum creatinine with a surge of sirolimus (Patient 2) and episodes of neutropenia and oral stomatitis (Patient 1) were observed. We diagnosed the first three patients with APDS1 in Korea. Low-dose sirolimus may alleviate clinical manifestations thereof, including hypogammaglobulinemia.