Lyme disease and pregnancy

What is Lyme disease?

Lyme disease is caused by a bacteria carried by an infected blacklegged tick (also called a deer tick). This type of tick usually lives in wooded areas, like forests, or in places with high grass and bushes. Lyme disease is most common in the northeast and upper Midwest of the United States. You can check with the Centers for Disease Control and Prevention (also called CDC) to see if you live in an area with Lyme disease.

Ticks that spread Lyme disease are very small (about the size of an apple seed) and may be hard to see. Young ticks can bite during the spring and summer, and adult ticks are more active during cooler months. Ticks can’t fly, but they can crawl onto you from a plant or an animal. 

A tick with Lyme disease has to be on your body for about 2 days before you can get infected. Ticks can bite you anywhere on your body. After being outside, make sure to check for ticks under your armpits, behind your knees, in your hair and around your groin. 

You can’t get Lyme disease from touching, kissing or having sex with someone who has Lyme disease. And you can’t pass it to your baby in breast milk. If you get infected with Lyme disease during pregnancy, it may cause problems for your baby. 

How can Lyme disease affect your pregnancy?

We don’t know for sure about the effects of Lyme disease on pregnancy. Untreated Lyme may cause complications during pregnancy, including:

• An infection in the placenta. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord. 
• Stillbirth. This is when a baby dies in the womb after 20 weeks of pregnancy.
• Congenital heart defects. These are heart conditions that are present at birth. They can affect the heart’s shape or how it works, or both. 
• Urinary tract defects. The urinary tract is the system of organs (like the kidneys and bladder) that helps your body get rid of waste and extra fluids. Urinary tract defects can cause pain, urinary tract infections, kidney damage and kidney failure. 
• Problems with your baby’s blood, like hyperbilirubinemia. This is when your baby’s blood has too much bilirubin in it. Bilirubin is a yellow substance that forms as red blood cells break down. Too much bilirubin can cause your baby to have jaundice. This is when your baby’s skin and the white parts of his eyes look yellow because his liver isn't fully developed or isn't working.

Untreated Lyme disease also may cause your baby to have a rash after he’s born.

What are the signs and symptoms of Lyme disease?

Signs and symptoms of Lyme disease depend on how long you’ve been infected. If you’re pregnant and have been bitten by a tick or live in or travelled to an area with Lyme disease, talk to your health care provider.

Early signs and symptoms (within about 1 month after being bitten) include:

• A rash called erythema migrans (also called EM). This rash looks like a bull’s eye around where the tick bit you. It may feel warm and may or may not be itchy. 
• Fatigue (being really tired and having little energy)
• Fever and chills
• Headache
• Muscle and joint pain
• Swollen lymph nodes. Lymph nodes are glands throughout the body that help fight infection. You usually can’t feel them unless they’re swollen. 

Later signs or symptoms (a few months after being bitten) include:

• Being short of breath
• Dizziness
• EM rash
• Facial paralysis. This is when you can’t feel or move parts of your face. 
• Joint pain and swelling
• Severe headache
• Stiff neck

If you have signs or symptoms of Lyme disease, tell your provider so you can get early treatment to help prevent complications. Your provider gives you a blood test to check for Lyme disease and other infections. It can take a few weeks to get test results about Lyme disease. 

You can have signs and symptoms even after you get treatment, sometimes for longer than 6 months. This is called post-treatment Lyme disease syndrome (also called PTLDS or chronic Lyme disease). If you don’t feel better after treatment, tell your provider. 

If Lyme disease isn’t treated, it can cause:

• An irregular heartbeat
• Inflammation (swelling) of the brain and spinal cord
• Tingling or numbness in your hands or feet

How is Lyme disease treated?

If you have Lyme disease, your provider treats you with antibiotics (medicine that kills infections). You may need to take the antibiotics for about 4 weeks. If you’re pregnant, don’t take the antibiotic doxycycline. Most women who get treatment during pregnancy have healthy babies.

How can you protect yourself from Lyme disease?

The only way to protect yourself from Lyme disease is to prevent tick bites. Here’s what you can do:

• Stay out of wooded areas or areas with tall grass
• Use an insect repellant (a product that keeps insects from biting you), like bug spray or lotion, that’s registered with the Environmental Protection Agency (also called EPA). All EPA-registered bug sprays and lotions are checked to make sure they’re safe and work well. To prevent tick bites, use a bug spray or lotion that contains 20 percent or more DEET, picaridin or IR3535. Or you can use a spray or lotion that contains a natural repellant called 2-undecanone. Always follow the instructions on the product label.
• Treat clothing with an insect repellant called permethrin. Check the product label to make sure it has at least 0.5 percent permethrin. 
• Take a shower after you spend time outside.
• Check your body and clothes for ticks.
• Wash and dry your clothes after being outside.

If you find a tick on you, remove it with tweezers. Here’s how:

• Make sure the tweezer is against your skin, and grab the tick near its head.
• Slowly pull the tick up and off of your skin. Don’t squeeze or crush the tick. Don’t use soap, lotion or petroleum jelly to help remove the tick.

After your remove the tick, clean your skin with soap and water or rubbing alcohol. 

Put the tick in rubbing alcohol or in a sealed bag or flush it down the toilet. Don’t crush the tick with your hands.

Last reviewed: June, 2017