Pregnancy and Early Neurodevelopmental Outcomes Following In Utero Lyme Disease Exposure

Childhood neurodevelopmental outcomes following antenatal Lyme disease exposure are not yet known. This pilot study will lay the groundwork for a larger study to determine the effect of in utero exposure to Lyme disease on pregnancy and early childhood neurodevelopmental outcomes. Understanding the effects on the developing brain is essential in order to inform timely prenatal and postnatal treatments to protect the fetus exposed to Lyme disease during pregnancy. Once childhood neurodevelopmental outcomes are known, appropriate follow-up and treatment guidelines can be developed to help better support children's developmental needs.

The primary aim of this study is to assess the feasibility of longitudinal follow-up of fetuses and infants exposed to Lyme disease in utero.Lyme disease in pregnancy and the impact on the fetus/child following in utero exposure has been identified as a priority research area; this pilot study is the essential step to plan a large study that will fill this knowledge gap and make a substantial contribution to the field.

The investigators will perform a prospective pilot longitudinal cohort study of B. burgdorferi-infected parents and their in-utero-exposed fetuses/infants. Patients included in this study will have a clinical diagnosis of Lyme disease during gestation or have been diagnosed with Lyme disease and/or PTLDS within 3 years preceding pregnancy.

Pregnant participants will receive a fetal MRI and ultrasound during the second or third trimesters of gestation. The investigators will conduct optional qualitative interviews with interested participants during their 3rd trimester to gather additional data on their experiences with Lyme disease/PTLDS during pregnancy. The placenta will be collected at birth and analyzed by an experienced placental pathologist per a standard protocol. Parent and infant blood will be tested for Lyme disease serology and markers of inflammation.

Following birth, infants will receive an unsedated brain MRI and a cranial ultrasound. The investigators will complete serial developmental evaluations using standardized assessments at multiple timepoints through age 18 months and receive neurological examinations. Throughout the study, participants will also be asked to complete questionnaires including but not limited to topics such as medical history, nutrition, breastfeeding, and socioeconomic information.

• Warner Initial Developmental Evaluation (WIDEA) [Срок оценки: Child ages: 2 months, 6 months, 12 months, 18 months]
• Ages and Stages Questionnaire (ASQ) [Срок оценки: Child ages: 2 months, 6 months, 12 months, 18 months]
• Alberta Infant Motor Scale (AIMS) [Срок оценки: Child ages: 2 months, 6 months, 12 months, 18 months]
• Infant height [Срок оценки: All study visits between birth - 18 months of age]
• Infant weight [Срок оценки: All study visits between birth - 18 months of age]
• Infant head circumference [Срок оценки: Birth - 18 months of age]
• Placental tissue analysis [Срок оценки: Placenta to be collected at delivery hospital immediately after birth]
• Analysis of parent and infant blood [Срок оценки: Adult: during pregnancy between 20-38 weeks gestational age, and between infant age 2-8 weeks; Child: Between ages 2-8 weeks]
• Fetal neuroimaging (Magnetic resonance imaging [MRI] and ultrasound) analysis [Срок оценки: During pregnancy between 20-38 weeks gestational age]
• Infant neuroimaging (Magnetic resonance imaging [MRI] and ultrasound) analysis [Срок оценки: Child age: Between 2-8 weeks]