Population-Based Linked Longitudinal Surveillance of Pregnant People and Their Infants: A Critical Resource for Emerging, Re-Emerging, and Persistent Threats

Abstract

Public health emergencies, from Zika to COVID-19, have underscored the importance of addressing the needs of pregnant people and their infants. Recent events have underlined the critical role of mother-infant-linked longitudinal surveillance to characterize and assess the impacts of emerging, re-emerging, and persistent threats, including infectious diseases, on these populations. In partnership with state, local, and territorial health departments, CDC's National Center on Birth Defects and Developmental Disabilities activated the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) to capture information about pregnant people with laboratory-confirmed infection with SARS-CoV-2 (the virus that causes COVID-19) and their infants. SET-NET data were critical in recognizing the severe risks of COVID-19 during pregnancy, which ultimately informed clinical decisions and public health policy, specifically vaccine prioritization at the local, state, and national levels. This commentary describes the activation of SET-NET to monitor COVID-19 in pregnancy and highlights the experiences of health departments. We provide examples of how SET-NET findings informed COVID-19 prevention efforts and public health policy. Lastly, we identify opportunities to improve and advance surveillance efforts to protect the health of pregnant people and their infants in the United States from current and future threats.

Keywords: COVID-19; emergency response; infant; pregnancy; surveillance.

FIG. 1.

Health departments and CDC: SET-NET data sources and collection. ELR, electronic laboratory reporting; EMR, electronic medical records; NNDSS, National Notifiable Diseases Surveillance System; SET-NET, Surveillance for Emerging Threats to Mothers and Babies Network.

FIG. 2.

Map of 31 state, local, and territorial sites, and potential coverage of live births in the United States, SET-NET, 2019–2022.

FIG. 3.

The 83% of surveyed jurisdictions perceive themselves as ready or more ready to conduct an emergency response using SET-NET for a new emerging threat after implementation of COVID-19 surveillance.

FIG. 4.

SET-NET major events with COVID-19 among pregnant people by week of diagnosis. Data were collected from 224,587 women and date of diagnosis was available for 224,587 (100%) women. Data: CDC COVID Data Tracker: Pregnant People: COVID-19 Illness and Outcomes.