Whilst patients and some researchers suspect various ways in which the Borrelia bacteria can be transmitted, so far the only proven methods are through tick bites, congenitally and, probably, via blood transfusions. In this guest blog post, the published evidence is summarised on congenital Lyme disease.
There is some confusion surrounding the issue of congenital Lyme disease, as some patients and even medical practitioners are unaware that the disease is proven to be transmissible this way.
There have been 46 cases of congenital Lyme disease documented in peer-reviewed research papers and, in total to date, 161 cases confirmed by microscopy, antibody testing and/or culture of live Borrelia from fetal samples, recorded by doctors who specialise in treating patients with Lyme disease.
One of the reasons for the confusion is that the majority of the earlier documented cases, which span the last 32 years, focused on babies who died shortly after birth, who were stillborn or miscarried. These fetuses could be thoroughly examined at autopsy in a way which living newborn babies cannot, but this resulted in a misconception that babies with congenital Lyme disease would always be stillborn. There are plenty of documented cases, however, which make it clear that this is not always the case.
The medical evidence concentrates on the most severe cases of gestational Lyme disease and this should not cause undue fear among expectant mothers suffering from the disease.
Pediatrician Dr. Charles Ray Jones and Dr. Richard Horowitz both report that out of the hundreds of patients they have seen, around two-thirds of mothers with Lyme disease who were not treated with antibiotics give birth to babies with congenital Lyme disease (and sometimes co-infections). However, very rarely does this result in the death of the baby or the severe, life-threatening symptoms and deformations reported in the peer-reviewed medical research.
Even more encouragingly, practitioners with clinical experience of treating mothers with Lyme disease, and the American Centers for Disease Control, agree that mothers given adequate antibiotic treatment for Lyme disease during pregnancy are unlikely to give birth to a child infected with, or affected by, Lyme disease.
If you have Lyme disease and are pregnant, you can make contact with some other women who have gone through Lyme disease pregnancies via the online patient support group Lyme Disease UK.
“Lyme disease acquired during pregnancy may lead to infection of the placenta and possible stillbirth; however, no negative effects on the fetus have been found when the mother receives appropriate antibiotic treatment.”
“Untreated, Lyme disease can be dangerous to your unborn child. Lyme disease that goes untreated can also cause you to have brain, nerve, spinal cord, and heart problems. With early treatment, these complications can be prevented. No life-threatening effects on the fetus have been found in cases where the mother receives appropriate antibiotic treatment for her Lyme disease. In general, treatment for pregnant women is similar to that of non-pregnant adults, although certain antibiotics, such as doxycycline, are not used because they can affect fetal development.”
Dr. Joseph Burrascano, who wrote Lyme disease and co-infection treatment guidelines, which summarises hundreds of peer-reviewed research papers, mentions the antibiotics recommended to treat women with Lyme disease during pregnancy to minimise the likelihood of transmission of the disease to the child.
“It is well known that B. burgdorferi can cross the placenta and infect the fetus. In addition, breast milk from infected mothers has been shown to harbor spirochetes that can be detected by PCR and grown in culture.
The Lyme Disease Foundation in Hartford, CT had kept a pregnancy registry for eleven years beginning in the late 1980s. They found that if patients were maintained on adequate doses of antibiotic therapy during gestation, then no babies were born with Lyme. My own experience over the last twenty years agrees with this.
The options for treating the mother include oral, intramuscular, and intravenous therapy as outlined above [refers to standard adult treatment protocols in the document found here]. It is vital that peak and trough antibiotic levels be measured if possible at the start of gestation and at least once more during treatment.
During pregnancy, symptoms generally are mild as the hormonal changes seem to mask many symptoms. However, post-partum, mothers have a rough time, with a sudden return of all their Lyme symptoms including profound fatigue. Post partum depression can be particularly severe. I always advise help in the home for at least the first month, so adequate rest and time for needed treatments are assured.
“I have had women who have had multiple miscarriages secondary to Lyme, where both the placenta and fetus showed evidence of infection…
Other tick-borne infections, such as the relapsing fever spirochete, as well as Babesia and Bartonella can also be transmitted to the fetus….
Woman in Wisconsin, USA was bitten during her first trimester and developed EM and typical Lyme disease symptoms
Lyme disease spirochetes were found in the baby’s spleen, kidneys, bone marrow and heart at autopsy.
Mother was tested for Lyme antibodies at three different laboratories and the result was positive from two of them. She tested negative for syphilis.
Five had adverse outcomes (one fetal death at 20 weeks, high bilirubin level in a four-week premature baby, webbed toes, blindness and developmental delay, and a newborn rash)
Consensus that this was an abnormally high frequency of adverse outcomes, and that pregnant women with diagnosed Lyme disease should be treated immediately with penicillin.
Williams and colleagues conducted a study in a Lyme-endemic area in New York of umbilical cord blood.
A glaring flaw in this study is that it only included live births. Since miscarriages, stillbirth and perinatal infant deaths were not included, the possibility of congenital defects possibly associated with Lyme and incompatible with life are not included!
This study is flawed because there is no autopsy data on the 12 miscarriages. In the 11 seronegative mothers who miscarried, Lyme disease may have been present and may have caused defective fetuses.
In 1988, Nadal surveyed 1,416 women and their 1,434 infants at delivery for presence of antibodies to the Lyme disease spirochete.
Nadal, D, Hunziker, UA, Bucher, HU, Hitzig, WH, Duc, G. Infants born to mothers with antibodies against Borrelia burgdorferi at delivery. Eur J Pediatr 1989; 148:426–427.