Lyme disease is a bacterial infection caused by Borrelia burgdorferi, a spiral-shaped bacterium transmitted to humans through the bite of infected black-legged ticks, also known as deer ticks. This condition represents the most common tick-borne illness across the Northern Hemisphere. Early indicators of Lyme disease often include a characteristic expanding red rash, known as erythema migrans, which can resemble a bull’s-eye pattern. Other initial symptoms may involve fever, headaches, and fatigue.
How Lyme Disease Can Be Transmitted
While Lyme disease is primarily transmitted through tick bites, maternal-fetal transmission is a concern for expectant parents. The Borrelia burgdorferi bacteria can cross the placenta from an infected pregnant mother to her developing fetus. This route of infection is referred to as congenital Lyme or vertical transmission. Although this spread is possible, it is considered rare, with likelihood increasing if the mother’s infection remains untreated. Importantly, Lyme disease is not transmitted to infants through breast milk.
Effects on Unborn and Newborn Children
When Lyme disease goes untreated in a pregnant person, potential consequences for the fetus can arise. These adverse outcomes are uncommon but may include infection of the placenta, spontaneous abortion (miscarriage), stillbirth, or preterm labor. The infection has also been associated with some congenital anomalies, such as heart defects. These severe outcomes are most often linked to cases where the maternal infection was not promptly addressed with appropriate treatment.
For newborns, symptoms of congenital Lyme disease can be non-specific and may include low birth weight or jaundice. Some infants have also presented with respiratory distress or developmental delays. Children born to mothers who had Lyme disease during pregnancy might experience cognitive challenges, learning disabilities, mood swings, or persistent fatigue.
Identifying and Treating During Pregnancy
Early diagnosis and treatment of Lyme disease in pregnant individuals are important for minimizing potential risks to both the mother and the developing fetus. Diagnosis involves evaluating the patient’s history of potential tick exposure, assessing clinical symptoms such as the characteristic erythema migrans rash, and performing laboratory tests. Blood tests, such as ELISA and Western blot, are commonly used, though they may not yield positive results until four to six weeks after illness onset.
Once diagnosed, specific antibiotic treatments are recommended for pregnant women. Oral amoxicillin or cefuroxime axetil are considered safe and effective options. These antibiotic courses typically last between 14 and 21 days. Doxycycline, an antibiotic commonly used for Lyme disease in non-pregnant adults, should be avoided as it can have adverse effects on fetal bone and tooth development during pregnancy. Prompt administration of these antibiotics helps reduce the risk of the infection spreading to the fetus.
Protecting Mother and Child
Preventing tick bites remains the most effective strategy for safeguarding both mother and child from Lyme disease. Pregnant individuals should take precautions, such as avoiding heavily wooded or tall grassy areas where ticks thrive. Wearing protective clothing, like long sleeves and pants, and using EPA-registered insect repellents containing ingredients such as DEET or picaridin, are effective measures. After spending time outdoors, performing thorough tick checks on the body is recommended, and any attached ticks should be removed promptly using fine-tipped tweezers, as infection typically requires at least 24 hours of attachment.
For infants born to mothers who had Lyme disease during pregnancy, careful monitoring is advised. If initial tissue samples from the infant test positive for Borrelia burgdorferi, early antibiotic treatment, typically initiated within four to six months of birth, often leads to favorable outcomes. Regular developmental assessments for the infant can help identify any potential concerns. By implementing these preventive measures and ensuring timely treatment if an infection occurs, the risks associated with Lyme disease during pregnancy can be significantly reduced.