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J Womens Health (Larchmt). 2019 Aug;28(8):1031-1036. doi: 10.1089/jwh.2019.7943.

Surveillance for Emerging Threats to Pregnant Women and Infants.

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1Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
2Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
3U.S. Public Health Service, Rockville, Maryland.
4Massachusetts Department of Public Health, Massachusetts Center for Birth Defects Research and Prevention, Boston, Massachusetts.
5Pennsylvania Department of Health, Bureau of Epidemiology, Harrisburg, Pennsylvania.
6Office of Science, Centers for Disease Control and Prevention, Atlanta, Georgia.


Recent public health emergencies have highlighted the unique vulnerabilities of pregnant women and infants to emerging health threats and the critical role of public health surveillance. Surveillance systems can collect critical data to measure the impact of a disease or disaster and can be used to inform clinical guidance and prevention strategies. These systems can also be tailored to collect data on vulnerable populations, such as pregnant women and their infants. Novel surveillance systems to assess risks and outcomes of pregnant women and infants have been established during public health emergencies but typically cease data collection once the public health response has ended, limiting our ability to collect data to understand longer-term outcomes. State-based birth defects surveillance systems are not available in all states, and no national surveillance system linking pregnancy exposure data to longitudinal outcomes for infants and children exists. In this report, we describe ongoing surveillance efforts to monitor congenital syphilis, Zika virus infection during pregnancy, and neonatal abstinence syndrome. We describe the need and rationale for an ongoing integrated surveillance system to monitor pregnant women and their infants and to detect emerging threats. We also discuss how data collected through this type of system can better position federal, state, and local health departments to more rapidly and comprehensively respond to the next public health emergency.


emerging threats; infants; infectious diseases; pregnant women; preparedness


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