Can Babesia Be Passed From Mother to Baby?
Babesia may rarely be passed from mother to baby during pregnancy
Congenital Babesia may appear weeks after delivery
Careful follow-up may help identify delayed symptoms in mothers and infants
Babesia passed from mother to baby during pregnancy is uncommon but documented in the medical literature. Congenital Babesia cases highlight the importance of recognizing tick-borne coinfections in pregnant women living in Lyme-endemic areas.
Saetre and colleagues described two mothers who transmitted Babesia microti to their infants during pregnancy. Both mothers were diagnosed with Lyme disease during the third trimester and later showed evidence of Babesia infection.
These cases raise important questions regarding diagnosis, monitoring, and treatment during pregnancy when Babesia symptoms may initially appear mild, delayed, or overlap with Lyme disease.
Can Babesia Be Transmitted During Pregnancy?
Babesia is a tick-borne parasite that infects red blood cells. The infection is most commonly spread through the bite of an infected deer tick, but it may also be transmitted through blood transfusion or, in rare cases, from mother to baby during pregnancy.
Pregnant women diagnosed with Lyme disease may also have evidence of Babesia and Lyme disease coinfection, particularly in endemic areas in the Northeast United States.
Because standard Lyme disease treatment does not treat Babesia, coinfections may be missed unless physicians continue monitoring for evolving symptoms, anemia, fevers, sweats, or changing laboratory findings.
First Mother With Babesia During Pregnancy
The first mother lived in Westchester County, New York, an area endemic for Lyme disease. She developed an erythema migrans rash and was diagnosed with Lyme disease during the third trimester at 32 weeks gestation.
She was treated with amoxicillin, a medication commonly prescribed during pregnancy for Lyme disease. However, amoxicillin does not treat Babesia infection.
Two weeks later, laboratory testing revealed positive Babesia IgM antibodies, suggesting early Babesia infection. The mother was not treated for Babesia.
Her baby boy later developed Babesia and required treatment approximately four and a half weeks after discharge from the hospital.
Follow-up testing later showed the mother had converted from Babesia IgM positivity to IgG positivity, supporting recent Babesia infection during pregnancy.
Second Mother With Babesia During Pregnancy
The second mother lived in nearby Putnam County, New York. She initially developed fever and muscle soreness before being diagnosed with Lyme disease during the third trimester at 37 weeks gestation.
Although her initial Babesia testing was negative, her baby girl tested positive for Babesia microti by PCR shortly after delivery.
The infant initially appeared healthy and was not treated. However, at 18 days old, Babesia organisms were identified in her red blood cells, and she required hospitalization, antimicrobial therapy, antiparasitic treatment, and blood transfusion.
Repeat testing later confirmed Babesia infection in the mother through PCR, IgM, and IgG testing.
Why These Cases Matter
These reports demonstrate that pregnant women may acquire Babesia during pregnancy and unknowingly pass the infection to their babies.
The cases also highlight several important clinical concerns:
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Babesia symptoms may initially be mild or delayed
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Routine Lyme disease treatment does not treat Babesia
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Babesia laboratory testing may evolve over time
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Infants may initially appear healthy before developing symptoms
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Follow-up monitoring may be important for both mother and child
These reports also raise important unanswered questions regarding the safest and most effective treatment approaches for Babesia during pregnancy.
Mother-to-Child Tick-Borne Infection Concerns
Pregnant women diagnosed with Lyme disease may also require evaluation for other tick-borne infections including ehrlichiosis, anaplasmosis, and Babesia.
Because symptoms may overlap, clinicians may need to reassess patients if fever, fatigue, anemia, sweats, or other unexplained symptoms continue after Lyme disease treatment.
These congenital Babesia cases also overlap with broader concerns regarding mother-to-child transmission of Lyme disease and other tick-borne infections during pregnancy.
Congenital Babesia remains uncommon, but these reports demonstrate why continued observation may be important in selected pregnancies involving tick-borne illness.
Frequently Asked Questions
Can Babesia be passed from mother to baby?
Yes. Although uncommon, Babesia may rarely be transmitted from mother to baby during pregnancy. Several congenital cases have been described in the medical literature.
Can Lyme disease treatment prevent Babesia transmission?
Not necessarily. Standard Lyme disease antibiotics such as amoxicillin do not treat Babesia infection.
What symptoms can congenital Babesia cause in infants?
Infants may develop fever, anemia, jaundice, irritability, feeding problems, or evidence of Babesia organisms in red blood cells. Some babies may initially appear healthy before symptoms emerge.
Can Babesia testing change over time?
Yes. Laboratory testing may evolve over weeks, including conversion from IgM positivity to IgG positivity or later PCR confirmation.
Should pregnant women with Lyme disease be monitored for Babesia?
In endemic regions, clinicians may consider Babesia evaluation when symptoms, laboratory findings, or tick exposure raise concern for coinfection.
Clinical Takeaway
Congenital Babesia remains uncommon, but these cases demonstrate that Babesia may occasionally be passed from mother to baby during pregnancy.
Pregnant women diagnosed with Lyme disease in endemic areas may benefit from continued monitoring for Babesia and other tick-borne coinfections, especially when symptoms evolve after initial treatment.
Early recognition of Babesia during pregnancy may help guide follow-up, testing, and treatment decisions for both mother and infant.
Related Articles
These related articles explore congenital Lyme disease, Babesia coinfections, pediatric tick-borne illness, and pregnancy-related Lyme disease concerns.
Babesia and Lyme Disease
Can Lyme Disease Be Passed From Mother to Child?
Why Pediatric Lyme Disease Is Misdiagnosed
Delayed Lyme Disease Diagnosis
Neurologic Lyme Disease
References
- Saetre K, Godhwani N, Maria M, et al. Congenital Babesiosis After Maternal Infection With Borrelia burgdorferi and Babesia microti. J Pediatric Infect Dis Soc. 2018;7(3):e149-e152.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I’m extremely interested in this topic. I have tested positive for Babesiosis. I have elevated HLA and C-Reactive Protein levels that fluctuate off the charts. I now have a child with Babesia and is suffering. He is now being treated, I was not. Furthermore, I suspect my other two children also have it as well. We are awaiting test results. What I’m trying to find out, is this:
1. Could my Babesia have been spread to ALL my children? Why are we not screening for this?
2. How likely is it congenital versus environmental?
3. What are long term effects of untreated Babesia?
My family lives in South Jersey. We took my 4 week old daughter to the hospital for a fever of 100.9. They did a spinal tap and various blood tests and found that she had Babesia. Doctors believe that I was bitten by a tick during pregnancy. Doctors at that hospital had never seen Babesia in a newborn before, but they knew exactly how to treat it. They gave her antibiotics and she ended up needing two blood transfusions to treat her anemia. We spent a week in the hospital. When we left her parasite levels were below 1% and her hemoglobin was at a 9.5. Very terrifying experience for a new mother and father to go through, but she is the perfect little baby now at two months old.