33 Years of Documentation of Maternal-Child Transmission of Lyme Disease and Congenital Lyme Borreliosis – A Review
by Sue Faber, RN, BScN
‘Transplacental transmission, adverse outcomes and reports of congenital infection of Borrelia Burgdorferi have been clearly documented over the last 33 years (1985 to 2018) by multiple international physicians, researchers, scientists and other experts. As entire families worldwide are affected by Lyme borreliosis resulting in serious debilitating illness and complex multi-systemic chronic infection, we must take this alternate mode of transmission – from mother to child in pregnancy, seriously.
For Lyme disease to be passed from mother to child in pregnancy drastically changes the narrative, we know that, it opens up new issues and challenges – however, recognizing it for what it is, is the right thing to do. It means upheaval and reordering and re-prioritizing in what has been taught and rethinking many areas of concern which perhaps have been looked over – but we must remember – we have no choice but to act with the highest integrity and honesty.
We have no option but to constructively engage, discuss and determine solutions and a clear path forward which will be a light for those who suffer, a beacon of Hope and healing. We need to prevent more miscarriages, stillbirths and babies from being born with Lyme and tick-borne illnesses – potentially leading to chronic pervasive, persistent and often disabling illness’. Sue Faber, RN.
https://www.lymehope.ca/uploads/8/4/2/8/84284900/updated_june_16_2018_-_32_years_of_literature_review_march_18_2018.pdf (Excerpt below. Please see link for more studies)
“Now we have found a spirochete capable of spreading transplacentally to the organs of the fetus, causing congenital heart disease and possible death of the infant.”
Dr. Willy Burgdorfer – The Enlarging Spectrum of Tick-Borne Spirochetoses: R. R. Parker Memorial Address, Reviews of Infectious Diseases. Vol 8, No 6. November-December 1986.
“It is clear that B. Burgdorferi can be transmitted in the blood of infected pregnant women across the placenta into the fetus. This has now been documented with resultant congenital infections and fetal demise. Spirochetes can be recovered or seen in infant’s tissues including the brain, spleen and kidney. The chronic villi of the placenta show and increase in Hofbauer cells as in luetic placentitis. Inflammatory changes of fetal or neonatal changes are not as pronounced as in the adult, but cardiac abnormalities, including intracardiac septal defects, have been seen. It is not known why inflammatory cells are so sparse from maternal transmission, but it is possible that an immature immune system plays a role.”
Dr Paul Duray and Dr Allen Steere – Clinical Pathologic Correlations of Lyme Disease by Stage. 1988.
“It is anticipated that more infants and fetuses with complications related to gestational Lyme borreliosis will be diagnosed in the future as the diagnosis is more frequently considered; it eventually will be possible to better describe the various clinical manifestations of congenital Lyme borreliosis.
“..in order for infants with congenital Lyme borreliosis and therefore initiation of prompt antibiotic therapy of the congenitally infected infant usually depend on suspicion or confirmation of Lyme borreliosis in the mother. Therefore, in order for infants with congenital Lyme borreliosis to be recognized, it is essential for clinicians caring for newborns and infants to become familiar with the various manifestations of Lyme borreliosis in the adult, as well as in the congenitally infected infant.”
“(serology) does not appear to be a sensitive method of diagnosis and reliance on sero-positivity leads to misdiagnosis of the majority of congenitally infected infants.”
“Large-scale, prospective studies of sufficient numbers of patients with Lyme borreliosis with follow-up to determine the pregnancy outcome of each enrolled patient; B burgdorferi-specific evaluation of any fetal or neonatal demise; and long-term follow-up of each infant born to determine the occurrence of possible early and late sequelae are needed.”
Dr. Tessa Gardner, Pediatric Infectious Disease MD, trained at Harvard University, 2001. Gardner, T. Lyme disease. In: Remington JK, J. editor. Infectious Diseases of the Fetus and Newborn. 5th ed: Saunders; 2001
“Transmission of Borrelia infection occurs via both zoonotic vectors and other humans. Congenital transfer is an established fact. Maternal to fetal transfer of Borrelia, can furthermore be clinically silent or unrecognized, and if not successfully treated, infection can be life long and latency, late activation and reactivation can occur.”
O’Brien J, Hamidi O. Lyme Disease (www.smgebooks.com). Infection with Borrelia: Implications for Pregnancy, Nov. 2017.
“Intra-human transfer of Borrelia can be initially silent or unrecognized’
‘The similarities of the clinical presentation of congenital syphilis to pregnancies with acute Lyme disease helps guide ante partum management. Due to the severity of previously documented cases, there should be a low threshold of suspicion to diagnose cases of Lyme disease in pregnancy.”
O’Brien J, Hamidi O. ‘Borreliosis Infection during Pregnancy’. Ann Clin Cytol Pathol 3(8). Oct. 2017.
“Pregnant women who are acutely infected with Borrelia burgdorferi (the primary cause of Lyme disease) and do not receive treatment have experienced multiple adverse pregnancy outcomes including preterm delivery, infants born with rash and stillbirth.”
“In obstetric patients acutely infected during the first trimester, a fetal echocardiogram is reasonable, given the demonstrated high potential of fetal cardiac abnormalities.’
O’Brien J, Baum, J. Case Report. The Journal of Family Practice. Vol 66, No 8, Aug, 2017.
“It was stated and proved transplacental transfer of borrelia”
“We need serious studies among pregnant women and newborn children in endemic regions…and in the future such patients should be monitored throughout pregnancy and after childbirth. Children born to these women should be examined for tick-borne infections at least during the first two years of life.”
Utenkova EO. Lyme disease and Pregnancy. Kirov State Medical Academy, Kirov Russia. Journal of Infectology, Volume 8, Number 2, 2016. *translated from Russian
“a new acronym is needed to include other, well-described cause of in utero infection: syphilis, enteroviruses, varicella zoster virus, HIV, Lyme disease (Borrelia burgdorferi) and parvovirus.”
“In utero infection and intrapartum infections may lead to late-onset disease. Such infections may not be apparent at birth but may manifest with signs and symptoms weeks, months or years later.”
Maldonado Y, Nizet V, Klein J et al. Current Concepts of Infections of the Fetus and Newborn Infant (Chapter 1). Found in Remington and Klein’s Infectious Diseases of the Fetus and Newborn Infant, 8th ed., 2016.
“Histological observations have confirmed the presence of Bb in children with congenital Lyme disease. It is interesting that spirochetes may exist in the spleen, kidney, bone marrow and nervous system.”
“The ability of long term survival of Bb sl in tissues and spreading of spirochetes in the body despite antibiotic treatment can contribute to intergenerational infection with Lyme disease.”
Jasik K, Okla H, Slodki J et al. Congenital Tick-Borne Diseases, is this an alternative route of transmission of tick- borne pathogens in mammals? Vector- Borne and Zoonotic Diseases, Volume 15, Number 11, 2015.
“these documented cases strongly suggest that transplacental transfer occurred via identification of Borrelia Burgdorferi in fetal tissues by culture, immunohistochemistry or indirect immunofluorescence.”
“the outcome of a pregnancy affected by Lyme disease remains relatively unknown and unstudied. However, it is still important to equip obstetrical patients with information that will help protect them against Lyme disease and provide treatment options if a suspected case of Lyme disease occurs during pregnancy.”
O’Brien JM, Martens MG. Lyme disease in Pregnancy, a New Jersey Medical Advisory. MD Advisor, 2014;7:24- 27.
“Borrelia Burgdorferi does appear to cross the placenta and infect the fetus. There are data to suggest an increased incidence of spontaneous abortion, stillbirth and congenital malformations associated with Lyme disease.”
“Adverse pregnancy outcomes are also more likely in women with untreated Lyme disease.”
Dotters-Katz S, Kuller J, Heine P. Arthropod-Borne Bacterial Diseases in Pregnancy. Obstetrical and Gynecological Survey, Vol 68(9). 2013.
“The parents of the five children in the study could not pinpoint an exact date of infection, but their treating physician suggested that the Bb bacteria could have been transmitted congenitally since all five of their mothers were diagnosed with Lyme disease and Bb has been shown to be transmitted congenitally in infected mothers. If the Bb bacteria were transmitted congenitally and this latency period presented itself in the infected children it could lead to an explanation of their late onset autistic symptomology.”
Kuhn M, Grave S, Bransfield R, Harris S. Long term antibiotics therapy may be an effective treatment for children co-morbid with Lyme Disease and Autism Spectrum Disorder. Medical Hypothesis (2012)
“The clinical picture of a fetus infected by B Burgdorferi is similar to that seen in the course of a syphilis infection. Most frequently they are: premature birth, intrauterine foetus death and malformation
“In the second stage of the illness, B. Burgdorferi traverses the placental barrier. Apart from foetal death, the following occur most frequently: syndactyly, sight loss, premature birth, neonatal rash, heart, liver, kidney damage or damage to the central nervous system.”
Relic, M, Relic, G. Lyme borreliosis and pregnancy. Vojnosanit Pregl 2012; 69(1):994-998. *translated from Polish