From the Guidelines
Chronic Lyme disease can potentially affect children in utero, though this is referred to as congenital Lyme disease, and prompt treatment with antibiotics like amoxicillin is recommended for pregnant women with Lyme disease. The Borrelia burgdorferi bacteria that causes Lyme disease can cross the placenta from an infected mother to her developing fetus, as noted in studies 1. This transmission is relatively rare but possible, especially if the mother has untreated active Lyme disease during pregnancy. Symptoms in affected newborns may include rash, jaundice, respiratory distress, fever, and neurological problems. For pregnant women with Lyme disease, prompt treatment with antibiotics like amoxicillin (typically 500mg three times daily for 2-3 weeks) is recommended, as this antibiotic is considered safe during pregnancy, according to guidelines 1. Doxycycline, which is commonly used for Lyme disease in non-pregnant patients, should be avoided during pregnancy due to its potential risks. Some key points to consider include:
- The risk of Lyme disease transmission to the fetus is relatively low, but prompt treatment is essential to prevent complications.
- Amoxicillin is the recommended antibiotic for pregnant women with Lyme disease, due to its safety profile 1.
- Prevention is crucial - pregnant women should take precautions against tick bites by wearing protective clothing, using appropriate insect repellents, and checking for ticks after outdoor activities.
- If a pregnant woman suspects Lyme disease, immediate medical attention is essential to reduce the risk of complications for both mother and baby, as emphasized in studies 1.
From the Research
Chronic Lyme Disease and In Utero Exposure
- Chronic Lyme disease is a poorly defined diagnosis that is usually given to patients with prolonged, unexplained symptoms or with alternative medical diagnoses 2.
- There is limited research on the effects of chronic Lyme disease on children in utero, but some studies suggest that maternal exposure to Lyme disease during pregnancy may not be associated with adverse pregnancy outcomes such as fetal death, prematurity, or congenital malformations 3.
- However, another study highlights the importance of distinguishing between acute Lyme disease and chronic Lyme disease, as the impacts of both conditions on the developing fetus and subsequent child development may differ 4.
Potential Effects on Neurodevelopment
- A review of the current state of knowledge on Lyme disease as a congenital infection suggests that in utero exposure to Lyme disease infection may have potential effects on the neurodevelopment of infants and children 4.
- The study emphasizes the need for future research to carefully collect potentially confounding variables such as symptomatology and treatment, use clear and standard case definitions, and follow children into school-age and beyond 4.
Diagnosis and Treatment
- The diagnosis of chronic Lyme disease is often controversial, and there is limited evidence to support the use of prolonged courses of antibiotics for treatment 2, 5.
- A network meta-analysis of 31 randomized controlled trials found that oral amoxicillin, oral azithromycin, injectable ceftriaxone, and injectable cefotaxime were effective for treating Lyme disease, while cefuroxime and penicillin were safe for treatment 6.