NEW! Publication on Perinatal Transmission of Lyme Disease: Advancing Scientific and Clinical Understanding of Lyme disease in pregnancy

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April 9, 2026 - Perinatal transmission of Borrelia burgdorferi: advancing scientific and clinical understanding of Lyme disease in pregnancy is published!

Press Release by Bay Area Lyme Foundation: https://www.bayarealyme.org/blog/new-peer-reviewed-publication-highlights-evidence-of-mother-to-child-transmission-of-lyme-disease-bacteria-during-pregnancy-and-calls-for-urgent-research/

What a privilege for LymeHope to be part of this incredible multidisciplinary team collectively addressing the issue of perinatal transmission of Lyme disease - a topic of public health importance and research significance.

We trust the recommendations in this paper will serve as stepping stones - uniting renewed interest and action within medicine and healthcare, academia/research institutions and government. We truly believe that we are in an exciting era of transformative research and policy which is anchored in collaborative partnerships and meaningful patient engagement. 

Recommendations identified in paper:

• Animal studies (murine, canine, primate) to clarify the pathobiology of LD in pregnancy and congenitally infected offspring. Evaluation of (a) potential vertical transmission of Bb in both acute and late-stage disease; (b) possible transmission through breast milk; (c) efficacy of pregnancy-safe antimicrobial therapy for maternal disease and prevention of fetal transmission; and (d) maternal and neonatal immune responses to infection, and possible immune-mediated mechanisms involved in both early and late presentations of disease acquired perinatally.
• Longitudinal prospective studies of pregnant women with LD and long-term follow-up of liveborn infants. This necessitates the development of standardized case definitions for gestational, fetal, and congenital LD, including clinical and laboratory criteria (119). Cases of fetal death or stillbirth require comprehensive evaluation for potential teratogenic and other adverse effects of Bb, including utilization of modern methods for direct detection of Borrelia spirochetes in placental and fetal tissues. Biorepository specimen collection, inclusive of maternal and infant blood, CSF, and other specimens (placenta, amniotic fluid, breast milk, urine, saliva and tissue) can be utilized for current or future studies (Figure 3).
• Development and validation of existing and new diagnostic testing approaches that enable accurate identification of gestational and congenital LD cases. These approaches may include evaluation of paired maternal-infant samples using next-generation serological assays, cellular immune testing and/or urine antigen tests. Newer direct testing methods such as droplet digital PCR, DNA hybridization microarrays and phage testing could be useful as well.
• Development of clinical guidelines for evaluation and management of pregnant women with LD and their at-risk infants. Comprehensive guidelines for diagnosis, treatment, and long-term management of pregnant women with LD and newborn infants are urgently needed, similar to those developed for other vector-borne infections such as Zika virus and West Nile virus. These clinical guidelines would be based on a comprehensive synthesis of existing evidence and updated as new evidence emerges.​

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