Table 2.
Unfavorable outcome of pregnancy in 42 patients after antibiotic treatment of erythema migrans.
| Pregnancy Trimester | Case No. (Year of Diagnosis) | Tick Bite | Onset of EM | Diagnosis of EM | Preterm Birth | Fetal a/Perinatal b Death | Anomalies (Evident at Birth or Later c), Other Abnormalities | Potential Explanations for Unfavorable Outcome |
|---|---|---|---|---|---|---|---|---|
| Week of Gestation | ||||||||
| First trimester | 1 (1998) | no | 2 | 3 | 11 a | |||
| 2 (1996) | 2 | 3 | 4 | syndactyly | anomaly present in family members | |||
| 3 (2002) | 3 | 4 | 4 | 16 a | uterus septus | |||
| 4 (2008) | no | 1 | 4 | 10 a | * | |||
| 5 (1997) | 3 | 5 | 5 | 33 d | pre-eclampsia at week 31 | |||
| 6 (1997) | no | 2 | 5 | 10 a | ||||
| 7 (1999) | −2 e | 4 | 5 | lacrymal canal stenosisc | ||||
| 8 (2008) | 2 | 5 | 6 | 10 a | multipara (6 children, 2 spontaneous abortions previously) * | |||
| 9 (1996) | 6 e | −2 e | 6 | 25 | 25 b | chorioamnionitis, vasculitis of umbilical vessels | ||
| 10 (2010) | 4 | 6 | 7 | 10 a | ||||
| 11 (1993) | no | 6 | 7 | 9 a | uterus bicornus | |||
| 12 (2013) | no | 4 | 8 | 32 d | ||||
| 13 (1997) | 9 | 9 | 10 | 25 | 25 b | |||
| 14 (1996) | 9 | 9 | 10 | 36 | thyroiditis during pregnancy | |||
| 15 (2010) | 8 | 9 | 10 | 35 d | partus imminens (hospitalization from gestational week 24) | |||
| 16 (2006) | 8 | 10 | 12 | 30 d | preterm premature rupture of membranes | |||
| 17 (2008) | 8 | 10 | 12 | 34 d | ||||
| 18 (2009) | no | 10 | 12 | 12 a | ||||
| 19 (1997) | no | 11 | 16 | ureteral stenosis, hydronephrosis, hydroureter dex c (apparent 10 months after birth) | ||||
| 20 (2010) | no | 11 | 16 | fetal growth retardation, CVI in perinatal period with consequent spasticity, left ovarian cyst | ||||
| 21 (2001) | 11 | 12 | 13 | 36 | ||||
| Summary | 13/21 (62%) | 6 (−2–12) | 7 (3–16) | 9/69 (13%) | 10/69 (14%) | 4/69 (6%) | 9/69 (13%) | |
| Second trimester | 22 (2005) | no | 13 | 14 | 36 | |||
| 23 (2000) | 12 | 15 | 16 | stenosis of pulmonary arteria, open foramen ovale | ||||
| 24 (2004) | 15 | 15 | 16 | 36 | hypospadia | |||
| 25 (1994) | 12 | 15 | 16 | 36 d | ASD, VSD | cervical insufficiency | ||
| 26 (1993) | no | 15 | 16 | 36 | ||||
| 27 (2001) | no | 18 | 19 | - | extrasystoles (shortly after birth, duration 3 weeks) | |||
| 28 (2006) | 16 | 20 | 20 | ASD, open foramen ovale, stenosis of pulmonary artery c (apparent 3 months after birth) | ||||
| 29 (2000) | 17 | 20 | 20 | VUR | ||||
| 30 (2001) | 18 | 19 | 20 | hearing deficit | ||||
| 31 (1993) | 19 | 20 | 21 | 26 d | uterus septus; cervical insufficiency | |||
| 32 (1994) | 18 | 19 | 22 | 36 | ||||
| 33 (2010) | 21 | 23 | 23 | 36 | month: ASD | |||
| 34 (2010) | no | 23 | 24 | 36 | ||||
| 35 (1992) | 22 | 23 | 24 | 36 | ||||
| 36 (2001) | no | 24 | 30 | 36 | * | |||
| 37 (2003) | 21 | 25 | 25 | 36 | ||||
| 38 (2004) | 15 | 26 | 28 | 35 f | ||||
| 39 (2004) | 26 | 28 | 28 | 36 | ** | |||
| Summary | 13/18 (72%) | 19 (13–28) | 20 (14–28) | 13/150 (9%) | − | 8/150 (5%) | 2/150 (1%) | |
| Third trimester | 40 (1995) | 31 | 32 | 32 | 5th month: VUR c | |||
| 41 (2007) | 33 | 34 | 34 | ASD, VSD, open ductus arteriosus Botalli | ||||
| 42 (1992) | no | 32 | 35 | 7th month: bilateral ureteral stenosis, hydronephrosis c | ||||
| Summary | 2/3 (67%) | 32 (32–34) | 34 (32–35) | 0/85 | − | 3/85 (4%) | 0/85 | |
Abbreviations: EM, erythema migrans; CVI, cerebrovascular insult; ASD, atrial septum defect; VSD, ventricular septum defect; VUR, vesicoureteral reflux. a Fetal death due to missed abortion (six patients) or spontaneous abortion (two patients); b live at birth, death occurred within few minutes; c later diagnosis of anomalies (within the first year after birth); d respiratory difficulties at birth; e weeks prior to conception; f respiratory distress syndrome and severe icterus at birth; * patient had multiple EM; ** isolation of Borrelia afzelii from blood.