A Preparedness Model for Mother–Baby Linked Longitudinal Surveillance for Emerging Threats

Abstract

Introduction Public health responses often lack the infrastructure to capture the impact of public health emergencies on pregnant women and infants, with limited mechanisms for linking pregnant women with their infants nationally to monitor long-term effects. In 2019, the Centers for Disease Control and Prevention (CDC), in close collaboration with state, local, and territorial health departments, began a 5-year initiative to establish population-based mother-baby linked longitudinal surveillance, the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Objectives The objective of this report is to describe an expanded surveillance approach that leverages and modernizes existing surveillance systems to address the impact of emerging health threats during pregnancy on pregnant women and their infants. Methods Mother-baby pairs are identified through prospective identification during pregnancy and/or identification of an infant with retrospective linking to maternal information. All data are obtained from existing data sources (e.g., electronic medical records, vital statistics, laboratory reports, and health department investigations and case reporting). Results Variables were selected for inclusion to address key surveillance questions proposed by CDC and health department subject matter experts. General variables include maternal demographics and health history, pregnancy and infant outcomes, maternal and infant laboratory results, and child health outcomes up to the second birthday. Exposure-specific modular variables are included for hepatitis C, syphilis, and Coronavirus Disease 2019 (COVID-19). The system is structured into four relational datasets (maternal, pregnancy outcomes and birth, infant/child follow-up, and laboratory testing). Discussion SET-NET provides a population-based mother-baby linked longitudinal surveillance approach and has already demonstrated rapid adaptation to COVID-19. This innovative approach leverages existing data sources and rapidly collects data and informs clinical guidance and practice. These data can help to reduce exposure risk and adverse outcomes among pregnant women and their infants, direct public health action, and strengthen public health systems.

COVID-19 Severity among Women of Reproductive Age with Symptomatic Laboratory-Confirmed SARS-CoV-2 by Pregnancy Status – United States, Jan 1, 2020 – Sep 30, 2021

“…5 Given the missingness of the pregnancy status variable on COVID-19 case reports, we supplemented information on pregnancy status with data from the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET), a population-based mother-baby linked longitudinal surveillance collaboration between CDC and state, local, and territorial health departments. 13 All cases reported to SET-NET are laboratory-con rmed SARS-CoV-2 infections during pregnancy. Pregnancy status information was also supplemented using free-text searches of the other symptoms elds and the other underlying conditions elds of the COVID-19 case reports.…”

Population birth data and pandemic readiness in Europe

“…It is being exploited in some countries to make further investigations possible, 11 and ambitious initiatives to provide longitudinal maternal–newborn databases for routine surveillance could provide a road map for the future. 12 Finally, a future plan should include procedures for the rapid international synthesis of data. Compiling data at a European level, a central objective of the PHIRI project, permits insight into the generalisability of national trends and generates knowledge to inform European policy.…”

SARS-CoV-2 infections among neonates born to women with SARS-CoV-2 infection: maternal, pregnancy and birth characteristics

“…The Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) is a collaboration between CDC and state, local, and territorial health departments to conduct linked-longitudinal surveillance of pregnant women and their infants to understand the effects of emerging and reemerging threats, including COVID-19. 8 Pregnant women with laboratory con rmed SARS-CoV-2 infection from January 20 to December 31, 2020, are retrospectively ascertained through reporting of pregnancy in COVID-19 surveillance and cross-matching of COVID-19 surveillance data with local data systems that contained data on births to assess pregnancy status. The data are then enhanced through a variety of supplemental data sources at the jurisdiction level including, but not limited to, vital statistics, prenatal screening data, administrative datasets, electronic laboratory reporting, and maternal and neonatal medical record review.…”