Lyme Disease Pregnancy Outcomes: What a New Survey Reveals

Researchers examined Lyme disease pregnancy outcomes using an international
cross-sectional survey to explore how Lyme disease during or around pregnancy may affect
maternal health and child outcomes.

Participants were recruited primarily through a Lyme disease–focused organization, although
eligibility was open to anyone over 18 years of age who had been pregnant. The study included
individuals who developed symptoms after pregnancy and those who were not treated for Lyme
disease (LD) for years after pregnancy despite being symptomatic beforehand.

Investigators compared participants diagnosed with Lyme disease or probable Lyme disease
with 200 participants (28%) who did not have Lyme disease.

Tick Exposure and Rash Recall

“Only 45% of diagnosed LD and 61% of suspected LD participants recalled a tick bite, and
less than 40% noticed an erythema migrans rash,”

wrote the authors.

Maternal Health During and After Pregnancy

Mothers who were more likely to have Lyme disease at the time of pregnancy were more likely
to report extreme fatigue, joint pain, fever of unknown origin, and postpartum depression
than participants without Lyme disease.

However, the authors were unable to determine whether these complications were directly
related to Lyme disease, pregnancy, or other contributing factors.

Pregnancy and Neonatal Outcomes

Children born to mothers who were more likely to have Lyme disease during pregnancy did not
differ from controls in gestational age at delivery, intrauterine growth restriction,
congenital anomalies, or rates of hyperbilirubinemia.

Childhood Health Findings

Children born to mothers who were more likely to have Lyme disease at the time of pregnancy
“demonstrated a wide range of pathologies, including musculoskeletal, gastrointestinal,
orthopedic, cardiovascular, respiratory, sleep, rashes, fevers, concentration, sensory,
and vision issues,” the authors report.

Importantly, the study could not determine whether these conditions were attributable to
Lyme disease, genetic factors, environmental exposures, or infections acquired after birth.

Study Limitations

The authors acknowledge several limitations. Recruitment was largely through Lyme
disease–based advocacy groups in North America, which may limit generalizability.

Recall bias is also a concern, as many pregnancies occurred 10 to 70 years before survey
completion. Additionally, as a cross-sectional study, causality cannot be established
without further prospective research.

Clinical Implications and Next Steps

Despite these limitations, the authors conclude, “This survey provides an important
foundation upon which hypotheses can be generated for many overdue projects focused on Lyme
disease in pregnancy.”

Furthermore, “our results support the hypothesis that parent treatment for Lyme disease
before or during pregnancy can attenuate severe pathology in neonates and children, but
does not eliminate poor outcomes entirely.”