Every May, Lyme Disease Awareness Month brings attention to the United States’ most common vector-borne disease (a disease spread by blood-feeding bugs like mosquitoes, ticks, and fleas). This year, we’re educating our readers on the possibility and effect of maternal-fetal transmission and what expecting mothers or women trying to get pregnant need to know about the most common disease that comes from a tick bite. Keep reading to learn more!
Key Takeaways
- Lyme disease is a vector-borne infectious disease spread through tick bites.
- The CDC recognizes congenital Lyme disease.
- Early diagnosis and treatment are crucial to ensuring the safety and health of expectant mothers and their babies.
What Is Lyme Disease?
While maternal-fetal transmission of Lyme disease is considered rare, over the last few decades, more research has emerged showing it does occur, especially if the mother does not receive treatment.
Proving that Lyme disease, caused by the Borrelia burgdorferi bacterium and spread by tick bites, can be passed from the mother to the baby during pregnancy has been a challenge for multiple reasons. The top among them is that Lyme disease is difficult to diagnose in adults, let alone the unborn. As a disease with many common symptoms that are also symptoms of other common illnesses and diseases, Lyme disease is often misdiagnosed and underdiagnosed.
The first stage of symptoms of Lyme disease includes headache, fatigue, flu-like symptoms, joint pain, and a rash that can appear in different shapes (not just the well-known bullseye rash). If the disease is not quickly diagnosed and treated, it can lead to long-term effects such as facial paralysis, neurological problems, cognitive impairment, hearing and vision problems, inflammation of the heart and brain, and more.
It’s also worth noting that testing for Lyme disease can be somewhat unreliable, as test accuracy depends on how long you’ve been infected. This is because it’s an antibody test looking for signs that your immune system has been trying to fight off the infection, which can take a while (around 4–6 weeks). Additionally, it’s not easy to determine if a patient has been cured after completing their antibiotic treatment, as their blood will likely continue to test positive for Lyme bacteria antibodies for months or years after the bacteria are gone.
Can Lyme Disease Cross the Placenta?
In 2020, the CDC acknowledged that Lyme disease can infect the mother’s placenta during pregnancy and, in rare cases, the baby. This is known as congenital Lyme or referred to as maternal-fetal transmission or vertical transmission. The possibility of transmission increases if the mother doesn’t receive treatment with antibiotics.
However, the Lyme disease community has long suspected this to be the case. A 2018 review published in PLOS One examined 45 studies and found that while it’s rare due to limited research, there is evidence of maternal-fetal transmission of Lyme disease bacteria. It goes on to suggest that adverse outcomes were more likely in cases where the disease was left untreated during the pregnancy. The review goes on to suggest that serious complications, including miscarriage or congenital abnormalities, were more likely when the mother didn’t receive immediate treatment.
In other instances, doctors such as Rosalie Greenberg, M.D., Child and Adolescent Psychiatrist, have documented their experience diagnosing congenital Lyme in children of mothers with Lyme disease. She notes how, without more research for doctors to draw upon, more children will suffer as Lyme disease is underdiagnosed or misdiagnosed in children of mothers who have or had Lyme disease.
Research Revelations and Shortcomings
As we mentioned earlier, one of the challenges in studying congenital Lyme disease is that it is difficult to prove, as the symptoms in infants often mimic those of many other common conditions. These symptoms can range from developmental delays to neurological or cardiac abnormalities. Still, some physicians and researchers like Dr. Greenberg have been able to document cases that strongly suggest vertical transmission happens more often than is reported.
Sue Faber, R.N., provides a literature review spanning 32 years, offering a comprehensive overview of repeated patterns across case studies. These include adverse pregnancy outcomes, the presence of spirochetes in fetal tissue, and infants born with Lyme-consistent symptoms, some of whom even test positive themselves.
Although the CDC states that there’s no evidence of Lyme being passed through breastfeeding, the research on this aspect of transmission still appears to be inconclusive.
More research is still needed to fully understand the scope and mechanics of congenital Lyme. Still, the existing evidence is enough to warrant caution and proactive care by expectant mothers and their OB-GYNs.
Why Early Diagnosis Matters During Lyme Disease Awareness Month
The good news is that timely antibiotic treatment is highly effective for mothers and babies. The CDC emphasizes that when Lyme disease is diagnosed early on in pregnant women, it is safe to treat with antibiotics like oral amoxicillin or cefuroxime; however, doxycycline can have adverse effects on fetuses and should be avoided during pregnancy. Early treatment dramatically decreases the risk of unborn babies contracting the disease and usually results in a full, quick recovery for mom.
RMC Supports Expecting Mothers Year-Round
As we recognize Lyme Disease Awareness Month, we want to ensure that all of our readers understand that RMC is here to take all of their health concerns seriously, especially those of women who are expecting. This joyful time also comes with concerns that can be overwhelming. If a tick has bitten you or you are experiencing multiple worrisome symptoms, our maternal medical care team is ready to ensure you and your baby are safe.
If you’re pregnant and think you may have been exposed to a tick, don’t wait. Contact RMC today to talk with a provider about your symptoms and get the care that you need!