The Next Generation of Lyme Disease – A Focus on Gestational Transmission


by Michelle McKeon, MS, CNS

Subscribe button

Lyme disease is the most common vector-borne disease, the most prevalent tick-borne disease, and one of the fastest-growing infectious diseases in the United States.1 There are many different factors that are contributing to this growing epidemic. Gestational Lyme disease (transferred infection from mother to baby in pregnancy) is a crucial component adding to the rise in numbers of this disease that are affecting people worldwide and often resulting in a serious debilitating illness. Over the past 35 years (1985-2020) evidence of transplacental transmission and congenital infection of Borrelia burgdorferi have been clearly reported. However, the longer this takes to get the recognition that it deserves will directly prolong the cataclysmic effects on pregnant women and their children. In the US, the Tick-Borne Disease Working Group submitted a 2018 report to Congress in which they acknowledged transplacental transmission of Lyme from mother to fetus.2 Furthermore, in March 2020 the committee agreed upon a recommendation to Congress for further research into this alternate mode of transmission: “Further evaluation of non-tick bite transmission of Lyme disease, for example maternal-fetal transmission.”2 The National Institute of Health also published the statement: “If you are pregnant, be especially careful to avoid ticks in Lyme disease areas because you can pass on the infection to your unborn child.”3

The current edition of a highly acclaimed, authoritative reference medical textbook, Remington and Klein’s Infectious Diseases of the Fetus and Newborn Infant, includes Lyme disease in their list of in-utero/congenital infections. They suggest that the well-known acronym TORCH (Toxoplasmosis, Other (T. pallidum, Varicella Zoster Virus, Parvovirus), Rubella virus, Cytomegalovirus and Herpes Simplex) is too limiting, and thus expanded to TORCHES-CLAP, with the L indicating Lyme disease.4 The Update on TORCH Infections in the newborn infant explains, “The usual way in which a fetus is infected is by transplacental spread after maternal infection in which the organism circulates in the mother’s blood. These infections, acquired in utero, can be severe enough to cause fetal loss or can result in intrauterine growth restriction, prematurity, or chronic postnatal infection.”5 It also states that “Clinical evidence of infection may be seen at birth, soon afterward, or not until years later.”5 By acknowledging that Lyme disease is not only a zoonotic disease but can also be transferred from mother to baby requires us to reevaluate what this means moving forward with this disease.

The CDC recently updated their website as well, stating:
If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately. Untreated Lyme disease during pregnancy can lead to infection of the placenta. Spread from mother to fetus is possible but rare. Fortunately, with appropriate antibiotic treatment, there is no increased risk of adverse birth outcomes. There are no published studies assessing developmental outcomes of children whose mothers acquired Lyme disease during pregnancy.5 Under recommendations for Lyme Disease and Breast Feeding, the CDC states, “There are no reports of Lyme disease transmission through breast milk.”6

Published Studies

The stealthy nature of gestational Lyme disease can manifest a complicated diagnosis, due to the delay or changing nature of symptoms, multisystemic effect on the body, and the unreliability of standard diagnostic tests. Syphilis, just like Lyme disease, is also caused by spirochetes. Therefore, it has often been thought that the disease developments have similarities when it comes to gestational transmission. Dr. Alan MacDonald, pathologist, published a comprehensive case series on gestational Lyme, including his findings from fetal autopsies. He states:
It is documented that transplacental transmission of the spirochete from mother to fetus is possible. Further research is necessary to investigate possible teratogenic effects that might occur if the spirochete reaches the fetus during the period of organogenesis. Autopsy and clinical studies have associated gestational Lyme borreliosis with various medical problems including fetal death, hydrocephalus, cardiovascular anomalies, neonatal respiratory distress, hyperbilirubinemia, intrauterine growth retardation, cortical, blindness, sudden infant death syndrome, and maternal toxemia of pregnancy. It is my expectation that the spectrum of gestational Lyme borreliosis will expand into many of the clinical domains of prenatal syphilis.7

Dr. Tessa Gardner, a pediatric infectious disease physician, authored a comprehensive chapter on Lyme disease in the 4th and 5th editions of Remington and Klein’s Infectious Diseases of the Fetus and Newborn Infant. Through her research, she discovered:
…a total of 46 cases of adverse outcomes of these 161 cases of gestational Lyme borreliosis were found, including miscarriage, stillbirth, perinatal death, congenital anomalies, systemic illness, early onset fulminant or mild sepsis and later-onset chronic progressive infection….Thirty-seven percent of the total number of adverse outcomes were miscarriages or fetal deaths, 11 percent were neonatal deaths and 48 percent were either fetal or neonatal deaths. The effect of antibiotic therapy was dramatic in these patients: with antibiotics, 85% of neonates were normal, while 15% had an adverse outcome. In striking contrast, without antibiotics, only 33% were normal, while 67% had an adverse outcome.8

Donate to the Townsend Letter

Dr. Charles Ray Jones is the world’s leading expert on pediatric tick-borne diseases, having treated more than 12,000 children.
According to Charles Ray Jones, MD, out of over 7,000 children seen, 300 (approximately 4%) have gestational Lyme. Data from his practice indicated that of 66 mothers with Lyme disease who were treated with antibiotics prior to conception and during the entire pregnancy, all gave birth to normal healthy infants. However, 8 pregnancies resulted in Borrelia burgdorferi and/or Bartonella henselae positive placentas, umbilical cords, and/or foreskin remnants. Those with positive PCRs were treated with 6 months of oral antibiotics and are without symptoms 3 months to 4 years later.9

…article continues on next page…