Lyme disease during pregnancy can contribute to which fetal outcomes?

• A. Stillbirth
• B. Heart defects
• C. Urinary tract defects and jaundice
• D. All of the above

Answer: (D)

Infections during pregnancy can affect the fetus in multiple ways, and Lyme disease is one example where adverse fetal outcomes have been reported, especially if the mother is not treated promptly. There is evidence that maternal Lyme disease can be associated with stillbirth, and there are rare reports of congenital Lyme manifestations that involve various organ systems. While not common, findings that resemble cardiac involvement, systemic illness with jaundice, or urinary tract abnormalities have appeared in some cases of congenital Lyme disease. Because the potential effects span several organ systems, the option that includes all listed outcomes best reflects the possible range of fetal consequences. In practice, early antibiotic treatment and careful fetal monitoring are important to reduce risk.