Woman Develops Lyme Disease Symptoms After Giving Birth
A WOMAN DEVELOPED LYME SYMPTOMS AFTER DELIVERY
BUT HER INFANT REMAINED HEALTHY
RAISING QUESTIONS ABOUT LYME DISEASE DURING PREGNANCY
A 23-year-old woman from Brooklyn, NY, developed Lyme disease symptoms shortly after giving birth to a healthy baby girl.
Three days after delivery, she visited her primary care doctor complaining of bilateral knee swelling and pain.
The pain was reported as 8/10 in severity and worsened with walking, according to the authors.
When the woman was 6 months pregnant, she experienced a similar episode of knee pain briefly but never sought treatment.
“Interestingly, except for a brief 2-day period where she experienced knee pain, she remained symptom-free for Lyme disease for the remainder of the pregnancy.”
During pregnancy, the woman had taken several trips to wooded areas in upstate New York.
She denied any known tick exposure or development of a rash.
Testing for Lyme disease was positive by Western blot with several reactive bands including 18, 23, 28, 33, 41, 43, 58, 66, and 93 kDa.
The woman’s symptoms improved following a 3-week course of doxycycline.
Pregnancy and Lyme Disease Symptoms
Lyme disease symptoms after giving birth may be difficult to recognize because fatigue, joint pain, sleep disruption, and cognitive complaints can overlap with common postpartum experiences.
In this case, the patient experienced only a brief episode of knee pain during pregnancy and otherwise remained symptom-free until after delivery.
This raises questions about whether hormonal or immune changes associated with pregnancy and the postpartum period may influence symptom expression in some patients.
No Evidence of Congenital Transmission in This Case
The infant remained symptom-free at birth and throughout early childhood.
“There was no evidence for congenital or perinatal transmission of this pathogen at any point pre-term or postnatally,” the authors state.
This case is reassuring because no evidence of congenital or perinatal transmission was identified.
At the same time, Lyme disease during pregnancy remains an area requiring further research and careful clinical judgment.
Clinical Perspective
Lyme disease symptoms after giving birth may create diagnostic uncertainty because postpartum symptoms can overlap with many other medical and physiologic conditions.
This case highlights the importance of considering tick-borne illness in patients with new joint swelling, pain, or inflammatory symptoms following pregnancy—particularly when there has been possible tick exposure.
However, this report did not identify evidence of congenital Lyme disease in the infant.
Learn more about pregnancy, breast feeding and Lyme disease, Lyme disease and pregnancy complications, and pregnancy outcomes in Lyme disease.
The Bottom Line
A woman developed Lyme disease symptoms shortly after giving birth following likely exposure during pregnancy.
Her infant remained healthy, and the authors found no evidence of congenital or perinatal Lyme transmission in this case.
Pregnancy-related Lyme disease questions remain incompletely understood and continue to require further study.
References:
- Pavia CS, Plummer MM, Varantsova A. An Unusual Case of Serologically Confirmed Post-Partum Lyme Disease Following an Asymptomatic Borrelia burgdorferi Infection Acquired during Pregnancy and Lacking Vertical Transmission in Utero. Pathogens. 2024 Feb 20;13(3):186. doi:10.3390/pathogens13030186.
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
