Fig 1.
The flow of citations and research papers through the systematic review process.
Fig 2.
The distribution of publication dates of 45 primary research publications relevant to the impact of gestational Lyme disease included in this systematic review grouped by studies that had epidemiological data or case report data.
Table 1.
General characteristics of 45 included primary research publications.
Table 2.
Summary of pregnancy outcomes from 59 case reports diagnosed with gestational Lyme disease and test results for direct detection of B. burgdorferi or spirochetes or antibodies against the agent of Lyme disease.
Table 3.
An overview of the features of 59 case reports diagnosed with gestational Lyme disease.
Table 4.
Measures of association extracted from eight studies on adverse birth outcomes and LD during or before pregnancy, positive LD serology during pregnancy, and surrogate measures of possible exposure to LD (e.g. tick bites or living in an endemic area).
(Significant odds ratios are bolded in the results.).
Fig 3.
Random effects meta-analysis of nine studies that reported the proportion of women with gestational Lyme disease that experienced an adverse birth outcome.
Studies were sub-grouped by treatment status: treated active LD, untreated LD that had a clinical history of LD symptoms, and seropositive with no history of LD. LD status was determined by retrospective medical record review, clinical diagnosis with and without serology or culture, or positive IgG and/or IgM serology. (NR = not reported, AO = Adverse outcome).
Table 5.
Measures of association extracted from six studies examining the odds of an adverse birth outcome in patients with gestational LD by treatment status, timing of exposure, severity and progression of LD.
(Significant odds ratios are bolded in the results.).