Longitudinal surveillance of priority exposures and outcomes among pregnant people and infants (Component A) - The purpose of this project is to sustain, improve, and expand surveillance efforts at clinical sites and health departments related to linked pregnant people and their infants. The ability to link mothers and infants and obtain data to follow them longitudinally ensures availability of timely, high-quality, modern, and efficient surveillance data related to reporting of key exposures and outcomes that impact pregnant people, infants, and children. The short-term and intermediate outcomes of this project include: improved surveillance data collection between clinical and public health partners; increased access and availability of electronic health record data; improved timely reporting of key exposures and outcomes that impact pregnant people and their infants, specifically associated with management and treatment of opioid use disorder during pregnancy (i.e., MOUD); improved surveillance system data that can be leveraged for emerging, reemerging, or persistent threats during pregnancy to pregnant people and their infants; increased awareness by CDC of the data and how the data are shared and processed between clinics and health departments for public health reporting; increased implementation of prevention activities and dissemination of findings; expanded and strengthened collaborative networks to address important public health issues that have an impact during pregnancy and to infants; and improved data structure and increased interoperability. Marshfield Clinic Health System (MCHS) offers four key strengths as a health system partner for conducting pregnant people-infant linked surveillance. First, we can access the electronic health record data in near real-time and have existing infrastructure to link pregnant people and their infants and longitudinally follow them through childhood. Second, our health system serves a predominantly rural patient population, who are disproportionally affected by opioid use disorder. Third, we have a successful track record of applied public health practice and collaborative research. Finally, we have a longstanding partnership with a community health center that operates three Alcohol and Drug Recovery Centers and maintains collaborative relationships with local stakeholders. MCHS will access, extract, and abstract electronic health record data from MCHS patients who are pregnant and their infants from pregnancy through age 6 for surveillance and submit these data to CDC. Specifically, we will capture data to improve understanding of maternal and infant outcomes associated with management and treatment of opioid use disorder (i.e., MOUD) during pregnancy among those with pregnancy outcomes during 2014 through 2023. Additionally, MCHS will collaborate with CDC programs and centers and other funded institutions and with federal, state, local, and community organizations though the HOPE Consortium. The HOPE Consortium was established to address growing problems associated with opioid misuse in rural, northern Wisconsin. Together, we will support implementation of the proposed strategies and activities for MOUD-related exposures, maximize public health impact, and contribute to long term goals of this project. Surveillance data and lessons learned will be disseminated to partners through scientific publications, presentations, or summary reports. A comprehensive approach that includes data from multiple health systems and health departments will strengthen existing surveillance system to improve public health strategies, innovate clinical recommendations, and identify novel findings related to pregnant people and their infants. This surveillance network infrastructure could be leveraged for emerging, reemerging, and persistent public health threats to pregnant people and infants.
