Pregnancy Among Reported Lyme Disease Cases—United States, 1992–2019

IF 2.4 2区农林科学 Q3 INFECTIOUS DISEASES Zoonoses and Public Health Pub Date : 2024-09-27 DOI:10.1111/zph.13183

Taylor D. Bostic, Kiersten J. Kugeler, Alison F. Hinckley

{"title":"Pregnancy Among Reported Lyme Disease Cases—United States, 1992–2019","authors":"Taylor D. Bostic, Kiersten J. Kugeler, Alison F. Hinckley","doi":"10.1111/zph.13183","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Lyme disease (LD), the most common vector-borne disease in the United States, typically presents with a localised erythema migrans rash (EM). Left untreated, infection can disseminate to cause severe heart, joint or nervous system manifestations. Summaries of LD surveillance data have been published previously but did not include the frequency, demographic or clinical characteristics of LD cases during pregnancy.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We summarised confirmed and probable LD cases by pregnancy status as reported to the U.S. Centers for Disease Control and Prevention during 1992–2019. We defined an LD case during pregnancy as one with (1) female sex, (2) age 14–49 years and (3) positive pregnancy indication. We evaluated the frequency, seasonality, age distribution, race and ethnicity, geographic distribution and clinical manifestations of LD cases during pregnancy and cases among non-pregnant females. We compared proportions using chi-squared tests.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 698,876 reported LD cases, 112,002 (16%) were confirmed or probable cases among females aged 14–49 years; 32,301 (29%) were specifically reported as non-pregnant and 643 (0.6%) (568 confirmed and 75 probable cases) reported as pregnant. Illness onset peaked in June among LD cases during pregnancy, but in July for cases among non-pregnant females. A higher proportion of confirmed LD cases during pregnancy had only EM rash than did cases among non-pregnant females (66% vs. 60%, <i>p</i> = 0.019).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>LD cases during pregnancy are rare. Compared to non-pregnant females, cases among pregnant females more commonly involve early clinical manifestations. These patterns could suggest earlier detection or more complete reporting of LD cases during pregnancy than their non-pregnant counterparts. Earlier detection could be due to frequent contact with healthcare or increased self-advocacy during pregnancy. Prompt antimicrobial treatment is critical for preventing severe disease and reducing risk of adverse pregnancy or birth outcomes.</p>\n </section>\n </div>","PeriodicalId":24025,"journal":{"name":"Zoonoses and Public Health","volume":"71 8","pages":"972-977"},"PeriodicalIF":2.4000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Zoonoses and Public Health","FirstCategoryId":"97","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/zph.13183","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Lyme disease (LD), the most common vector-borne disease in the United States, typically presents with a localised erythema migrans rash (EM). Left untreated, infection can disseminate to cause severe heart, joint or nervous system manifestations. Summaries of LD surveillance data have been published previously but did not include the frequency, demographic or clinical characteristics of LD cases during pregnancy.

Methods

We summarised confirmed and probable LD cases by pregnancy status as reported to the U.S. Centers for Disease Control and Prevention during 1992–2019. We defined an LD case during pregnancy as one with (1) female sex, (2) age 14–49 years and (3) positive pregnancy indication. We evaluated the frequency, seasonality, age distribution, race and ethnicity, geographic distribution and clinical manifestations of LD cases during pregnancy and cases among non-pregnant females. We compared proportions using chi-squared tests.

Results

Among 698,876 reported LD cases, 112,002 (16%) were confirmed or probable cases among females aged 14–49 years; 32,301 (29%) were specifically reported as non-pregnant and 643 (0.6%) (568 confirmed and 75 probable cases) reported as pregnant. Illness onset peaked in June among LD cases during pregnancy, but in July for cases among non-pregnant females. A higher proportion of confirmed LD cases during pregnancy had only EM rash than did cases among non-pregnant females (66% vs. 60%, p = 0.019).

Conclusions

LD cases during pregnancy are rare. Compared to non-pregnant females, cases among pregnant females more commonly involve early clinical manifestations. These patterns could suggest earlier detection or more complete reporting of LD cases during pregnancy than their non-pregnant counterparts. Earlier detection could be due to frequent contact with healthcare or increased self-advocacy during pregnancy. Prompt antimicrobial treatment is critical for preventing severe disease and reducing risk of adverse pregnancy or birth outcomes.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

1992-2019年美国莱姆病报告病例中的怀孕情况。

背景：莱姆病（LD）是美国最常见的病媒传染病，通常表现为局部红斑迁徙性皮疹（EM）。如不及时治疗，感染可能扩散，导致严重的心脏、关节或神经系统症状。以前曾发表过 LD 监测数据摘要，但未包括孕期 LD 病例的频率、人口统计学或临床特征：我们总结了美国疾病控制和预防中心在 1992-2019 年期间报告的按妊娠状态划分的确诊和疑似 LD 病例。我们将妊娠期 LD 病例定义为：(1) 女性；(2) 年龄 14-49 岁；(3) 妊娠指征阳性。我们评估了孕期 LD 病例和非孕期女性病例的频率、季节性、年龄分布、种族和民族、地理分布和临床表现。我们使用卡方检验对比例进行了比较：在报告的 698,876 例 LD 病例中，112,002 例（16%）是 14-49 岁女性中的确诊病例或疑似病例；32,301 例（29%）明确报告为非孕期病例，643 例（0.6%）（568 例确诊病例和 75 例疑似病例）报告为孕期病例。在妊娠期的退伍军人症病例中，发病高峰在 6 月份，而非妊娠期女性病例的发病高峰则在 7 月份。在确诊的妊娠期 LD 病例中，仅出现 EM 皮疹的比例高于非妊娠期女性病例（66% 对 60%，P = 0.019）：结论：妊娠期LD病例很少见。与非孕期女性相比，孕期女性的病例更常见于早期临床表现。这些模式可能表明，与非孕期女性相比，孕期 LD 病例更早发现或报告更全面。较早发现的原因可能是孕期经常接触医护人员或自我保护意识增强。及时的抗菌治疗对于预防严重疾病和降低不良妊娠或分娩结局的风险至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Zoonoses and Public Health 医学-传染病学

CiteScore

5.30

自引率

4.20%

发文量

115

审稿时长

6-12 weeks

期刊介绍： Zoonoses and Public Health brings together veterinary and human health researchers and policy-makers by providing a venue for publishing integrated and global approaches to zoonoses and public health. The Editors will consider papers that focus on timely collaborative and multi-disciplinary research in zoonoses and public health. This journal provides rapid publication of original papers, reviews, and potential discussion papers embracing this collaborative spirit. Papers should advance the scientific knowledge of the sources, transmission, prevention and control of zoonoses and be authored by scientists with expertise in areas such as microbiology, virology, parasitology and epidemiology. Articles that incorporate recent data into new methods, applications, or approaches (e.g. statistical modeling) which enhance public health are strongly encouraged.