Obstetrical and Neonatal Outcomes in Women With Gestational Lyme Disease [ID: 1354384

Abstract

INTRODUCTION: The incidence of Lyme disease (LD) infections has risen in recent decades. Gestational LD has been associated with adverse pregnancy outcomes; however, the results have been contradictory. The objective of this study was to examine the effects of gestational LD on obstetrical and neonatal outcomes. METHODS: Using the Healthcare Cost and Utilization Project–National Inpatient Sample database from the United States, we conducted a retrospective cohort study of pregnant women who were admitted to hospital between 2016 and 2019. The exposed group consisted of pregnant women with gestational LD infection (ICD-10 code of A692x), whereas the comparison group consisted of pregnant women without gestational LD. Descriptive statistics and multivariate logistic regression models, adjusted for baseline maternal characteristics, were used to determine the associations between gestational LD and obstetrical and neonatal outcomes. RESULTS: Our cohort included 2,943,575 women, 226 of whom were diagnosed with LD during pregnancy. The overall incidence of gestational LD was 7.67 per 100,000 pregnancy admissions. The incidence of gestational LD was stable during the study period. Women with gestational LD were more likely to be Caucasian, older, have private health insurance, and earn higher incomes than the comparison group. Gestational LD was associated with an increased risk of placental abruption (adjusted odds ratio [aOR] 3.45, 95% CI 1.53–7.80) and preterm birth (aOR 1.58, 95% CI 1.03–2.42). CONCLUSION: Gestational LD is associated with a higher risk of placental abruption and preterm birth. Pregnancies complicated by LD may benefit from being closely monitored in tertiary care settings.