175: Tracking Threats to Pregnancy Health

Dr. Karen Remley, Director of the National Center on Birth Defects and Developmental Disabilities with the CDC, discusses the SET-NET project to protect the health of pregnant people and their babies; Dr. Philip LoBue, Director of the Division of...

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Dr. Karen Remley, Director of the National Center on Birth Defects and Developmental Disabilities with the CDC, discusses the SET-NET project to protect the health of pregnant people and their babies; Dr. Philip LoBue, Director of the Division of Tuberculosis Elimination for the CDC, puts tuberculosis infection rates into context; and the ASTHO Public Health TechXpo kicks off today, but there’s still time to sign up.

CDC Webpage: Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET)

CDC Webpage: Treat TB Campaign

ASTHO Website: Public Health TechXpo

ASTHO News Release: Getting Ahead of the Next Pandemic, Leaders Convene to Identify Solutions to Transform U.S. Health Data

ASTHO logo



This is Public Health Review Morning Edition for Tuesday, May 10, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


Ever since the Zika epidemic that started in 2015, public health leaders have been working to develop and improve a surveillance network to protect pregnant people and their babies from disease.

In recognition of National Women's Health Week, we thought it a good time to get the latest on the SET--NET project from Dr. Karen Remley, a former state health official in Virginia, now the director of the National Center on Birth Defects and Developmental Disabilities at the CDC. It's the morning conversation.

What makes this network so unique?


So, SET-NET—or Surveillance for Emerging Threats to Mothers and Babies—is really unique because it is a national surveillance network. Think about.it started during Zika because we all were worried and we all wanted to know what is the impact of the infection of Zika on a pregnant woman and on her baby. And we were hearing reports, but we didn't have a comprehensive way to collect that data. So, that was really the origins of SET-NET.

And we were able to establish this national surveillance system that follows a woman from her exposure—whether it be Zika, we've expanded that to hepatitis C, syphilis, and most recently COVID-19—throughout her pregnancy, so the impact that infection might have on her pregnancy; and then, very importantly, delivery, and following the baby. So, it's just critically important that, as we develop this national surveillance network, that we're learning how to use it for more and different infections, more and different exposures. If we had had this when the lead crisis happened in Flint, we would have been able to look at what was the impact on lead during pregnancy?

So, we're really setting up that network across the country.


How does public health use information from the network?


So, we use this data—most recently, during COVID-19—to begin to learn about, yes, it's more likely if you're pregnant not to get infected, because you're younger, right? S,o pregnant women were less likely to get infected. But we learned very quickly that if they were pregnant with COVID, they were more likely to have a significant illness.

And so, really important to have that information early on to help inform mothers, people who are pregnant, about making sure they did the social distancing, masking, all the things we needed to do, because they needed to know they were at higher risk.

And then, as we were able to use the same information to be able to look at the impact of vaccination, the impact of oral antivirals—all of that information comes out very quickly out of SET-NET. It is able to then be turned rapidly around into guidance information to local health departments, directly to mothers and babies, and pregnant women, to their physicians, and to state health departments.


How does the network prepare to deal with the next public health crisis?


You know, we don't know what the next threat will be. But what we do know is no matter what it is, people ultimately are always very worried about women during pregnancy, and babies. It's a particular part of our culture and our society that everyone wants to make sure they’re as protected as they can be.

Setting up this network, having the expertise exist across the country to rapidly be able to share that data, bring that data in, be able to look at it with different regions, different socioeconomic statuses, different cultures, and be able to rapidly engage and act will make a huge difference, whatever that next event might be. And we will be able to better protect mothers and babies rather than learning years later, but really be able to do it in a very timely way.


Read more about the SET-NET project using the link in the show notes.


Everyone in public health is working to understand what happened to tuberculosis infection rates during the first year of the pandemic. The number of cases fell to historic lows, but was it masking and social distancing, misdiagnosis, or something else?

Dr. Philip LoBue is director of the Division of Tuberculosis Elimination at the CDC. For him, one thing is certain.


Before COVID, TB was clearly the number one infectious cause of sudden respiratory infection in terms of causing deaths and substantial morbidity. So globally, there probably about 10 million or so cases of TB every year and probably about one and a half million deaths. And when COVID ends—you know, pandemics generally end—that's what we're gonna go back too, right. So, TB will be number one again.


The CDC has a new campaign to reach people who have TB but don't even know it. There's a link to the webpage in the show notes.


Finally, this is the first day of the ASTHO Public Health TechXpo, but you can still sign up today. At 1 p.m. Eastern Time, Microsoft chief medical officer Dr. David Rhew kicks off the event with a discussion about verifiable clinical information and consumer centric care. Also, Guidehouse presents a panel on HIV data; Amazon Web Services is part of a conversation about the role of the cloud in supporting public health.

The online conference runs through tomorrow. There is no charge for most people. Get more information with the link in the show notes.


Before we go, we want to remind you to follow the show on your podcast app. And if you're on Twitter, Instagram, Facebook, or LinkedIn, we'd love a shout out.

That'll do it for today's newscast. We're back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.


Director, Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC

Karen Remley MD MPH

Director, National Center on Birth Defects and Developmental Disabilities, CDC