The following is a summary of “Extended Risk of Mortality in Children with Inborn Errors of Metabolism: A Longitudinal Cohort Study,” published in the JANUARY 2023 issue of Pediatrics by Auger, et al.

For a study, researchers sought to calculate the long-term mortality risk for kids with metabolic inborn abnormalities.

They performed a retrospective cohort analysis on 1,036,668 infants without metabolic errors and 1,750 children with inborn metabolic errors (excluding mitochondrial illnesses) born in Quebec, Canada, between 2006 and 2019. Mortality from all causes and cause-specific causes between birth and age 14 were the primary end measures. They used adjusted survival regression models to estimate HRs and 95% CIs for the link between inborn metabolic errors and death across time.

Children with metabolic mistakes had higher mortality rates than unaffected children (69.1 vs. 3.2 deaths per 10,000 person-years). Inborn metabolic errors were linked to a 21.2 times higher risk of death during the course of 7,702,179 person-years of follow-up as compared to those who did not have a metabolic mistake (95% CI 17.23-26.11). In the first 28 days of life, disorders of mineral metabolism were linked to higher mortality (HR 60.62, 95% CI 10.04-365.98), while those related to sphingolipid metabolism were linked to higher mortality at 1 year (HR 284.73, 95% CI 139.20-582.44) and at 14 years (HR 1066.00, 95% CI 298.91-3801.63). Death from hepatic/digestive (HR 208.21, 95% CI 90.28-480.22), respiratory (HR 116.57, 95% CI 71.06-191.23), and infectious (HR 119.83, 95% CI 40.56-354.04) causes were disproportionately correlated with errors of metabolism.

Children with metabolic disorders were far more likely to die before age 14, including infectious, hepatic/digestive, and respiratory diseases. By focusing on these causes of mortality, long-term survival may be increased.

Reference: jpeds.com/article/S0022-3476(22)00789-2/fulltext