Lyme disease is an illness caused by bacteria known as Borrelia burgdorferi, and rarely, B. mayonii in the United States. These bacteria are transmitted to humans through the bite of infected blacklegged ticks. Ticks acquire the bacteria from infected wildlife and then spread them to humans during a bite.
Understanding Vertical Transmission
Vertical transmission of Lyme disease from mother to unborn child is rare but acknowledged by medical authorities. This transmission can occur when the Borrelia bacteria cross the placenta and infect the fetus. While the risk is recognized, widespread conclusive evidence of frequent or severe outcomes from such transmission remains limited.
The CDC indicates that untreated Lyme disease during pregnancy can lead to placental infection, and that spread from mother to fetus is possible but rare. Despite these acknowledgments, definitively proving congenital Lyme disease presents challenges due to diagnostic complexities.
Potential Effects on the Fetus and Newborn
If vertical transmission occurs, potential outcomes for the fetus or newborn are uncommon. Untreated Lyme disease during pregnancy may lead to an infection of the placenta and can result in stillbirth in rare cases. Other reported complications include developmental abnormalities, such as hydrocephalus or cortical blindness, and heart problems, like cardiovascular anomalies.
Newborns might also experience issues such as hyperbilirubinemia or respiratory distress. Many pregnant women who contract Lyme disease go on to have healthy babies, especially with appropriate treatment. The exact spectrum of effects remains an area of ongoing research.
Diagnosis and Management During Pregnancy
Diagnosing Lyme disease in pregnant women involves evaluating symptoms, considering exposure history, and conducting blood tests. Initial symptoms often include a characteristic expanding red rash called erythema migrans, which appears at the tick bite site, along with fever, headaches, and tiredness. Blood tests, such as ELISA and Western blot, are used, though a blood test for Lyme disease might not be positive until 4-6 weeks after the onset of illness.
Early diagnosis and prompt treatment are important for pregnant individuals. The recommended antibiotic treatments for Lyme disease during pregnancy include oral amoxicillin or oral cefuroxime axetil for 2-3 weeks. Certain antibiotics, such as doxycycline, are avoided during pregnancy due to potential effects on fetal bone and tooth development. Appropriate antibiotic treatment of the mother can significantly reduce the risk of adverse outcomes for the baby.
Protecting Your Pregnancy
Preventing tick bites is the most effective way to protect against Lyme disease during pregnancy. When spending time outdoors, particularly in wooded or grassy areas, it is advisable to wear long-sleeved shirts and pants, tucking pants into socks to minimize skin exposure. Using EPA-registered insect repellents containing ingredients like DEET, picaridin, or IR3535 is also recommended, as these are considered safe for use during pregnancy when applied according to product instructions.
After outdoor activities, performing thorough tick checks on clothing and skin is important. Ticks can be very small and can hide in areas like armpits, behind knees, in hair, and around the groin. If a tick is found, it should be removed promptly and correctly using fine-tipped tweezers, grasping the tick as close to the skin as possible and pulling upward with steady pressure. Cleaning the bite area with rubbing alcohol or soap and water afterwards is also advised.