LYME-DISEASE AND PREGNANCY OUTCOME - A PROSPECTIVE-STUDY OF 2000 PRENATAL PATIENTS

OBJECTIVE: The purpose of the study was to determine if prenatal expos ure to Lyme disease was associated with an increased risk of adverse p regnancy outcome. STUDY DESIGN: Approximately 2000 Westchester County, New York, women completed questionnaires and had sera tested for anti body to Borrelia burgdorferi at their first prenatal visit and at deli very. Fetal death, birth weight, length of gestation at delivery, and congenital malformations were examined in relation to maternal Lyme di sease exposure before and during pregnancy. RESULTS: Maternal Lyme dis ease or an increased risk of exposure to Lyme disease was not associat ed with fetal death, decreased birth weight, or length of gestation at delivery. Tick bites or Lyme disease around the time of conception wa s not associated with congenital malformations. Tick bites within 3 ye ars preceding conception were significantly associated with congenital malformations, but this could have reflected reporting differences be tween exposed and unexposed women. CONCLUSIONS: Maternal exposure to L yme disease before conception or during pregnancy is not associated wi th fetal death, prematurity, or congenital malformations taken as a wh ole. We have not ruled out the possibility that exposure to Lyme disea se as defined by maternal history increases the risk of specific malfo rmations or has an effect if it is not treated. We have insufficient n umbers of women who were seropositive at their first prenatal visit to determine if this subgroup of exposed women are at a moderately incre ased risk of having a child with a congenital abnormality. The low fre quency of seroconversion at delivery in this endemic area suggests tha t preventive measures are being taken by obstetricians and patients.