Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Lyme Disease Pregnancy

Note

Black-legged or deer ticks (BLT) are found throughout Nova Scotia

The risk of Lyme disease after a bite from an infected BLT is low (1.2-3.2%); however, if a bite occurs, advise observation for signs and symptoms for 30 days, even if there has been prophylaxis

Prevention

Preventing a BLT bite is the most effective way to prevent Lyme disease

Risk reduction strategies

  • Strategies include using DEET-containing insect repellant (safe to use in pregnancy) and careful 'tick checks' after being in grassy or wooded areas, including a park or yard

  • Immediate and correct removal of an attached BLT is key to prevention

  • For advice about tick removal

Prophylaxis may be considered

ALL of the following criteria must be met:

  • BLT attached for ≥24 hours AND

  • Antibiotic prophylaxis is give ≤72 hours from tick removal AND

  • The bite occurred in an area considered at higher or moderate risk for Lyme disease, which is most of NS For risk level by NS County, see map

Treatment of Lyme in Pregnancy

Treatment for pregnant women with Lyme disease is similar to treatment for the general adult population, with the exception that treatment doses of doxycycline are contraindicated in pregnancy

With 10-28 days of oral antibiotic treatment, 95% of cases of Lyme disease are resolved

Treatment recommendations

Treatment recommendations

Evidence does not support vertical transmission of Borrelia burgdorferi that results in adverse fetal or obstetrical outcomes.

There is no evidence to suggest that pregnancy affects the manifestations or severity of Lyme disease in the mother.

Babies born to mothers with Lyme disease during pregnancy should be referred to a paediatric infectious disease specialist if there are any clinical concerns.

Implications of breastfeeding

At this time, the evidence does not support transmission of Borrelia burgdorferi through breastfeeding. There is no evidence of vertical transmission of Lyme disease and thus breastfeeding is not contraindicated in women with Lyme disease and can be encouraged.

For more information

More Information

For more information about Lyme disease, please refer to the following websites: