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Lyme disease and pregnancy loss

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Summer’s pleasures include hiking, biking and barbecues in the great outdoors. Like all enjoyable hot weather activities, from camping to simple strolls in wooded areas, these enjoyable pastimes carry with them the potential for tick bites and Lyme disease, particularly in certain states. Lyme disease is passed onto humans by blacklegged ticks, whose bites often go unnoticed. If contracted and left untreated, Lyme disease can cause miscarriage and stillbirth in some women.

Early-stage Lyme disease is often, though not always, characterized by a red, bulls-eye rash which widens over time and makes its first appearance between 3-30 days after infection occurs. Other early symptoms include headache, fever, chills, muscle aches and nagging fatigue. While symptoms typically become more severe over time, some early cases of Lyme disease are asymptomatic or have subtle, short-term symptoms which can easily be overlooked. For this reason, it is important to maintain vigilance about avoiding tick bites if you live in states where Lyme disease is prevalent. According to the Centers for Disease Control and Prevention the states where Lyme disease is most prevalent include:

  • Connecticut
  • Delaware
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • New Hampshire
  • New Jersey
  • New York
  • Pennsylvania
  • Vermont
  • Virginia
  • Wisconsin

In order to avoid tick bites, the CDC recommends use of an insect repellent containing DEET or permethrin, however, women who are pregnant or attempting pregnancy may have concerns about insecticide use in general, and DEET in particular, as the CDC also cautions that DEET is known to cross the placenta and has not been thoroughly studied in pregnant women. There is no evidence that permethrin is any safer and is only recommended for use in pregnant women when the benefits outweigh the risks.

Connecticut has long been considered the epicenter for this tick-borne infection. “Living in Connecticut, Lyme disease is always on our radar,” says Dr. Mark Leondires, a reproductive endocrinologist practicing in that state. “When infertility patients present with even vague symptoms of joint pain, unexplained tiredness, headaches, or perhaps insomnia, we recommend they get testing for Lyme disease with their primary care physician. Lyme disease can be difficult to diagnose and, since it is associated with pregnancy loss and stillbirth, we want to identify possible cases as early as possible. The good news is, even if someone is pregnant and found to have Lyme disease there are medications that can be used for treatment which are safe in pregnancy,” he adds.

Avoiding Lyme disease is preferable to treating it, whether you are attempting pregnancy or not. Home-made, natural tick repellents may afford some protection but it also makes sense to avoid heavily wooded areas and tall grass and to cover your skin and head when outside. If you suspect you have been bitten by a tick or are displaying any of the early signs of Lyme disease, you should also get tested immediately.

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