Maternal Lyme borreliosis and pregnancy outcome

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: There is disagreement regarding whether Lyme borreliosis is associated with adverse pregnancy outcome. Methods: We performed a review of the data from 95 women with Lyme borreliosis during pregnancy, evaluated at the Center for Tick-borne Diseases, Budapest over the past 22 years. Results: Treatment was administered parenterally to 66 (69.5%) women and orally to 19 (20%). Infection remained untreated in 10 (10.5%) pregnancies. Adverse outcomes were seen in 8/66 (12.1%) parentally treated women, 6/19 (31.6%) orally treated women, and 6/10 (60%) untreated women. In comparison to patients treated with antibiotics, untreated women had a significantly higher risk of adverse pregnancy outcome (odds ratio (OR) 7.61, p = 0.004). While mothers treated orally had an increased chance (OR 3.35) of having an adverse outcome compared to those treated parenterally, this difference was not statistically significant (p = 0.052). Erythema migrans did not resolve by the end of the first antibiotic course in 17 patients. Adverse pregnancy outcome was more frequent among these 'slow responder' mothers (OR 2.69), but this was not statistically significant (p = 0.1425) . Loss of the pregnancy (n = 7) and cavernous hemangioma (n = 4) were the most prevalent adverse outcomes in our series. The other complications were heterogeneous. Conclusion: Our results indicate that an untreated maternal Borrelia burgdorferi s.l. infection may be associated with an adverse outcome, although bacterial invasion of the fetus cannot be proven. It appears that a specific syndrome representing 'congenital Lyme borreliosis' is unlikely.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
Volume14
Issue number6
DOIs
Publication statusPublished - Jun 2010

Fingerprint

Lyme Disease
Pregnancy Outcome
Mothers
Odds Ratio
Pregnancy
Tick-Borne Diseases
Anti-Bacterial Agents
High-Risk Pregnancy
Cavernous Hemangioma
Borrelia burgdorferi
Erythema
Infection
Fetus

Keywords

  • Borrelia burgdorferi s.l. Infection
  • Lyme disease
  • Pregnancy loss
  • Pregnancy outcome

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Maternal Lyme borreliosis and pregnancy outcome. / Lakos, A.; Solymosi, N.

In: International Journal of Infectious Diseases, Vol. 14, No. 6, 06.2010.

Research output: Contribution to journalArticle

@article{0f2f8c6289a64f7fb4d01a244b725664,
title = "Maternal Lyme borreliosis and pregnancy outcome",
abstract = "Background: There is disagreement regarding whether Lyme borreliosis is associated with adverse pregnancy outcome. Methods: We performed a review of the data from 95 women with Lyme borreliosis during pregnancy, evaluated at the Center for Tick-borne Diseases, Budapest over the past 22 years. Results: Treatment was administered parenterally to 66 (69.5{\%}) women and orally to 19 (20{\%}). Infection remained untreated in 10 (10.5{\%}) pregnancies. Adverse outcomes were seen in 8/66 (12.1{\%}) parentally treated women, 6/19 (31.6{\%}) orally treated women, and 6/10 (60{\%}) untreated women. In comparison to patients treated with antibiotics, untreated women had a significantly higher risk of adverse pregnancy outcome (odds ratio (OR) 7.61, p = 0.004). While mothers treated orally had an increased chance (OR 3.35) of having an adverse outcome compared to those treated parenterally, this difference was not statistically significant (p = 0.052). Erythema migrans did not resolve by the end of the first antibiotic course in 17 patients. Adverse pregnancy outcome was more frequent among these 'slow responder' mothers (OR 2.69), but this was not statistically significant (p = 0.1425) . Loss of the pregnancy (n = 7) and cavernous hemangioma (n = 4) were the most prevalent adverse outcomes in our series. The other complications were heterogeneous. Conclusion: Our results indicate that an untreated maternal Borrelia burgdorferi s.l. infection may be associated with an adverse outcome, although bacterial invasion of the fetus cannot be proven. It appears that a specific syndrome representing 'congenital Lyme borreliosis' is unlikely.",
keywords = "Borrelia burgdorferi s.l. Infection, Lyme disease, Pregnancy loss, Pregnancy outcome",
author = "A. Lakos and N. Solymosi",
year = "2010",
month = "6",
doi = "10.1016/j.ijid.2009.07.019",
language = "English",
volume = "14",
journal = "International Journal of Infectious Diseases",
issn = "1201-9712",
publisher = "Elsevier",
number = "6",

}

TY - JOUR

T1 - Maternal Lyme borreliosis and pregnancy outcome

AU - Lakos, A.

AU - Solymosi, N.

PY - 2010/6

Y1 - 2010/6

N2 - Background: There is disagreement regarding whether Lyme borreliosis is associated with adverse pregnancy outcome. Methods: We performed a review of the data from 95 women with Lyme borreliosis during pregnancy, evaluated at the Center for Tick-borne Diseases, Budapest over the past 22 years. Results: Treatment was administered parenterally to 66 (69.5%) women and orally to 19 (20%). Infection remained untreated in 10 (10.5%) pregnancies. Adverse outcomes were seen in 8/66 (12.1%) parentally treated women, 6/19 (31.6%) orally treated women, and 6/10 (60%) untreated women. In comparison to patients treated with antibiotics, untreated women had a significantly higher risk of adverse pregnancy outcome (odds ratio (OR) 7.61, p = 0.004). While mothers treated orally had an increased chance (OR 3.35) of having an adverse outcome compared to those treated parenterally, this difference was not statistically significant (p = 0.052). Erythema migrans did not resolve by the end of the first antibiotic course in 17 patients. Adverse pregnancy outcome was more frequent among these 'slow responder' mothers (OR 2.69), but this was not statistically significant (p = 0.1425) . Loss of the pregnancy (n = 7) and cavernous hemangioma (n = 4) were the most prevalent adverse outcomes in our series. The other complications were heterogeneous. Conclusion: Our results indicate that an untreated maternal Borrelia burgdorferi s.l. infection may be associated with an adverse outcome, although bacterial invasion of the fetus cannot be proven. It appears that a specific syndrome representing 'congenital Lyme borreliosis' is unlikely.

AB - Background: There is disagreement regarding whether Lyme borreliosis is associated with adverse pregnancy outcome. Methods: We performed a review of the data from 95 women with Lyme borreliosis during pregnancy, evaluated at the Center for Tick-borne Diseases, Budapest over the past 22 years. Results: Treatment was administered parenterally to 66 (69.5%) women and orally to 19 (20%). Infection remained untreated in 10 (10.5%) pregnancies. Adverse outcomes were seen in 8/66 (12.1%) parentally treated women, 6/19 (31.6%) orally treated women, and 6/10 (60%) untreated women. In comparison to patients treated with antibiotics, untreated women had a significantly higher risk of adverse pregnancy outcome (odds ratio (OR) 7.61, p = 0.004). While mothers treated orally had an increased chance (OR 3.35) of having an adverse outcome compared to those treated parenterally, this difference was not statistically significant (p = 0.052). Erythema migrans did not resolve by the end of the first antibiotic course in 17 patients. Adverse pregnancy outcome was more frequent among these 'slow responder' mothers (OR 2.69), but this was not statistically significant (p = 0.1425) . Loss of the pregnancy (n = 7) and cavernous hemangioma (n = 4) were the most prevalent adverse outcomes in our series. The other complications were heterogeneous. Conclusion: Our results indicate that an untreated maternal Borrelia burgdorferi s.l. infection may be associated with an adverse outcome, although bacterial invasion of the fetus cannot be proven. It appears that a specific syndrome representing 'congenital Lyme borreliosis' is unlikely.

KW - Borrelia burgdorferi s.l. Infection

KW - Lyme disease

KW - Pregnancy loss

KW - Pregnancy outcome

UR - http://www.scopus.com/inward/record.url?scp=77952240190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952240190&partnerID=8YFLogxK

U2 - 10.1016/j.ijid.2009.07.019

DO - 10.1016/j.ijid.2009.07.019

M3 - Article

C2 - 19926325

AN - SCOPUS:77952240190

VL - 14

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

SN - 1201-9712

IS - 6

ER -