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June 27, 1986, Vol 255, No. 24 >
ARTICLE | June 27, 1986

Lyme Disease During Pregnancy FREE

Lauri E. Markowitz, MD; Allen C. Steere, MD; Jorge L. Benach, PhD; John D. Slade, MD; Claire V. Broome, MD
[+] Author Affiliations

Reprint requests to Respiratory and Special Pathogens Epidemiology Branch, Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Markowitz).


JAMA. 1986;255(24):3394-3396. doi:10.1001/jama.1986.03370240064038
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References

Lyme disease is an increasingly recognized tick-borne illness caused by a spirochete, Borrelia burgdorferi. Because the etiologic agent of Lyme disease is a spirochete, there has been concern about the effect of maternal Lyme disease on pregnancy outcome. We reviewed cases of Lyme disease in pregnant women who were identified before knowledge of the pregnancy outcomes. Nineteen cases were identified with onset between 1976 and 1984. Eight of the women were affected during the first trimester, seven during the second trimester, and two during the third trimester; in two, the trimester of onset was unknown. Thirteen received appropriate antibiotic therapy for Lyme disease. Of the 19 pregnancies, five had adverse outcomes, including syndactyly, cortical blindness, intrauterine fetal death, prematurity, and rash in the newborn. Adverse outcomes occurred in cases with infection during each of the trimesters. Although B burgdorferi could not be implicated directly in any of the adverse outcomes, the frequency of such outcomes warrants further surveillance and studies of pregnant women with Lyme disease.

(JAMA 1986;255:3394-3396)

REFERENCES

1 +
Burgdorfer W, Barbour AG, Hayes SF, et al:  Lyme disease: A tick-borne spirochetosis? Science 1982;;216:1317-1319.
2 +
Benach JL, Bosler EM, Hanrahan JP, et al:  Spirochetes isolated from the blood of two patients with Lyme disease . N Engl J Med 1983;;308:740-742.
3 +
Steere AC, Grodzicki RL, Kornblatt AN, et al:  The spirochetal etiology of Lyme disease . N Engl J Med 1983;;308:733-740.
4 +
Steere AC, Malawista SE, Hardin JA, et al:  Erythema chronicum migrans and Lyme arthritis: The enlarging clinical spectrum . Ann Intern Med 1977;;86:685-698.
5 +
Marcus LC, Steere AC, Duray PH, et al:  Fatal pancarditis in a patient with coexistent Lyme disease and babesiosis: Demonstration of spirochetes in the myocardium . Ann Intern Med 1985;;103:374.
6 +
Steere AC, Duray PH, Kauffmann DJH, et al:  Unilateral blindness caused by infection with the Lyme disease spirochete Borrelia burgdorferi . Ann Intern Med 1985;;103:381.
7 +
Johnston YE, Duray PH, Steere AC, et al:  Lyme arthritis: Spirochetes found in synovial microangiopathic lesions . Am J Pathol 1985;; 118:26-34.
8 +
Steere AC, Hutchinson GJ, Rahn DW, et al:  Treatment of the early manifestations of Lyme disease . Ann Intern Med 1983;;99:22-26.
9 +
Steere AC, Pachner AR, Malawista SE:  Neurologic abnormalities of Lyme disease: Successful treatment with high-dose intravenous penicillin . Ann Intern Med 1983;;99:767-772.
10 +
Steere AC, Green J, Schoen RT, et al:  Successful parenteral penicillin therapy of established Lyme arthritis . N Engl J Med 1985;; 312:869-874.
11 +
Schlesinger PA, Duray PH, Durk BA, et al:  Maternal-fetal transmission of the Lyme disease spirochete, Borrelia burgdorferi . Ann Intern Med 1985;;103:67.
12 +
Craft JE, Grodzicki RL, Steere AC:  Antibody response in Lyme disease: Evaluation of diagnostic tests . J Infect Dis 1984;;149:789-795.
13 +
Russell H, Sampson JS, Schmid GP, et al:  Enzyme-linked immunosorbent assay and indirect immunofluorescence assay for Lyme disease . J Infect Dis 1984;;149:465-470.
14 +
Johnson SE, Klein GC, Schmid GP, et al:  Lyme disease: A selective medium for isolation of the suspected etiologic agent, a spirochete . J Clin Microbiol 1984;;19:81-82.
15 +
Barbour AG, Burgdorfer W, Hayes SF, et al:  Isolation of a cultivable spirochete from Ixodes ricinus ticks of Switzerland . Curr Microbiol 1983;;8:123-126.
16 +
Taber LH, Feigin RD:  Spirochetal infections . Pediatr Clin North Am 1979;;26:377-413.
17 +
Coghlan JD, Bain AD:  Leptospirosis in human pregnancy followed by death of the foetus . Br Med J 1969;;1:228-230.
18 +
Chung HL, Ts'ao WC, Mo PS, et al:  Transplacental or congenital infection of leptospirosis . Chinese Med J 1963;;82:777-782.
19 +
Fuchs PC, Oyama AA:  Neonatal relapsing fever due to transplacental transmission of Borrelia . JAMA 1969;;208:690-692.
20 +
Shirts SR, Brown MS, Bobitt JR:  Listeriosis and borreliosis as causes of antepartum fever . Obstet Gynecol 1983;;62:256-261.
21 +
Steenbarger JR:  Congenital tick-borne relapsing fever: Report of a case with first documentation of transplacental transmission . Birth Defects 1982;;18:39-45.
22 +
Omar ME:  Rare complications of louse borne relapsing fever . J Egypt Public Health Assoc 1946;;2:195-200.
23 +
Gaud M, Morgan MT:  Epidemiological study of relapsing fever in North Africa (1943-45) . Bull WHO 1947;-1948;1:69-92.
24 +
Lane R, Burgdorfer W, Hayes SF, et al:  Isolation of a spirochete from the soft tick, Ornithdoros coriaceus: A possible agent of epizootic bovine abortion . Science 1985;;230:85-87.
25 +
Ellis WA, O'Brien JJ, Niell SD, et al:  Bovine leptospirosis: Serological findings in aborting cows . Vet Rec 1982;;110:178-180.
26 +
National Center for Health Statistics: Advance Report of Final Natality Statistics, 1982 , publication 84-1120. Hyattsville, Md, Public Health Service, 1984;, vol 33( (suppl) ), p 5.
27 +
Harlap S, Shiono PH, Ramcharans:  A life table of spontaneous abortions and the effects of age, parity, and other variables , in Hook EB (ed): Embryonic and Fetal Death . New York, Academic Press Inc, 1980;, pp 145-158.
28 +
Shrestha M, Grodzichi RL, Steere AC:  Diagnosing early Lyme disease . Am J Med 1985;;78:235-240.

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1 +
Burgdorfer W, Barbour AG, Hayes SF, et al:  Lyme disease: A tick-borne spirochetosis? Science 1982;;216:1317-1319.
2 +
Benach JL, Bosler EM, Hanrahan JP, et al:  Spirochetes isolated from the blood of two patients with Lyme disease . N Engl J Med 1983;;308:740-742.
3 +
Steere AC, Grodzicki RL, Kornblatt AN, et al:  The spirochetal etiology of Lyme disease . N Engl J Med 1983;;308:733-740.
4 +
Steere AC, Malawista SE, Hardin JA, et al:  Erythema chronicum migrans and Lyme arthritis: The enlarging clinical spectrum . Ann Intern Med 1977;;86:685-698.
5 +
Marcus LC, Steere AC, Duray PH, et al:  Fatal pancarditis in a patient with coexistent Lyme disease and babesiosis: Demonstration of spirochetes in the myocardium . Ann Intern Med 1985;;103:374.
6 +
Steere AC, Duray PH, Kauffmann DJH, et al:  Unilateral blindness caused by infection with the Lyme disease spirochete Borrelia burgdorferi . Ann Intern Med 1985;;103:381.
7 +
Johnston YE, Duray PH, Steere AC, et al:  Lyme arthritis: Spirochetes found in synovial microangiopathic lesions . Am J Pathol 1985;; 118:26-34.
8 +
Steere AC, Hutchinson GJ, Rahn DW, et al:  Treatment of the early manifestations of Lyme disease . Ann Intern Med 1983;;99:22-26.
9 +
Steere AC, Pachner AR, Malawista SE:  Neurologic abnormalities of Lyme disease: Successful treatment with high-dose intravenous penicillin . Ann Intern Med 1983;;99:767-772.
10 +
Steere AC, Green J, Schoen RT, et al:  Successful parenteral penicillin therapy of established Lyme arthritis . N Engl J Med 1985;; 312:869-874.
11 +
Schlesinger PA, Duray PH, Durk BA, et al:  Maternal-fetal transmission of the Lyme disease spirochete, Borrelia burgdorferi . Ann Intern Med 1985;;103:67.
12 +
Craft JE, Grodzicki RL, Steere AC:  Antibody response in Lyme disease: Evaluation of diagnostic tests . J Infect Dis 1984;;149:789-795.
13 +
Russell H, Sampson JS, Schmid GP, et al:  Enzyme-linked immunosorbent assay and indirect immunofluorescence assay for Lyme disease . J Infect Dis 1984;;149:465-470.
14 +
Johnson SE, Klein GC, Schmid GP, et al:  Lyme disease: A selective medium for isolation of the suspected etiologic agent, a spirochete . J Clin Microbiol 1984;;19:81-82.
15 +
Barbour AG, Burgdorfer W, Hayes SF, et al:  Isolation of a cultivable spirochete from Ixodes ricinus ticks of Switzerland . Curr Microbiol 1983;;8:123-126.
16 +
Taber LH, Feigin RD:  Spirochetal infections . Pediatr Clin North Am 1979;;26:377-413.
17 +
Coghlan JD, Bain AD:  Leptospirosis in human pregnancy followed by death of the foetus . Br Med J 1969;;1:228-230.
18 +
Chung HL, Ts'ao WC, Mo PS, et al:  Transplacental or congenital infection of leptospirosis . Chinese Med J 1963;;82:777-782.
19 +
Fuchs PC, Oyama AA:  Neonatal relapsing fever due to transplacental transmission of Borrelia . JAMA 1969;;208:690-692.
20 +
Shirts SR, Brown MS, Bobitt JR:  Listeriosis and borreliosis as causes of antepartum fever . Obstet Gynecol 1983;;62:256-261.
21 +
Steenbarger JR:  Congenital tick-borne relapsing fever: Report of a case with first documentation of transplacental transmission . Birth Defects 1982;;18:39-45.
22 +
Omar ME:  Rare complications of louse borne relapsing fever . J Egypt Public Health Assoc 1946;;2:195-200.
23 +
Gaud M, Morgan MT:  Epidemiological study of relapsing fever in North Africa (1943-45) . Bull WHO 1947;-1948;1:69-92.
24 +
Lane R, Burgdorfer W, Hayes SF, et al:  Isolation of a spirochete from the soft tick, Ornithdoros coriaceus: A possible agent of epizootic bovine abortion . Science 1985;;230:85-87.
25 +
Ellis WA, O'Brien JJ, Niell SD, et al:  Bovine leptospirosis: Serological findings in aborting cows . Vet Rec 1982;;110:178-180.
26 +
National Center for Health Statistics: Advance Report of Final Natality Statistics, 1982 , publication 84-1120. Hyattsville, Md, Public Health Service, 1984;, vol 33( (suppl) ), p 5.
27 +
Harlap S, Shiono PH, Ramcharans:  A life table of spontaneous abortions and the effects of age, parity, and other variables , in Hook EB (ed): Embryonic and Fetal Death . New York, Academic Press Inc, 1980;, pp 145-158.
28 +
Shrestha M, Grodzichi RL, Steere AC:  Diagnosing early Lyme disease . Am J Med 1985;;78:235-240.

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