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Public health surveillance is the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation, and evaluation of public health practice. The information collected by these systems is used for assessing public health status, defining public health priorities, evaluating programs, and stimulating research. The public health approach to problem solving includes using surveillance data to identify problems and assessing the effectiveness of interventions.

Reproductive health surveillance has primarily been used to monitor the risks of reproductive complications. Maternal and infant mortality have been the primary outcomes of interest. However, today we monitor many intermediate morbidity outcomes, which may be precursors to mortality, and useful as indicators of societal health.

In 1989, WHO convened a working group to discuss how to improve research on reproductive morbidity. The group concluded that long-term consequences of pregnancy and childbirth were understudied. As a result of this working group’s efforts and due to new legislative mandates, current surveillance activities were enhanced and new surveillance activities were instituted to monitor the risks of pregnancy.

CDC's Division of Reproductive Health (DRH) has surveillance systems that monitor both morbidity and mortality related to pregnancy. DRH conducts surveillance with both passive and active surveillance or reproductive health conditions including surveillance of adolescent pregnancy; assisted reproductive technology; the incidence, characteristics, and risk factors associated with ectopic pregnancy; the number and characteristics of women who have had a hysterectomy in the United States; deaths from pregnancy and childbirth, and the number and characteristics of women obtaining legal induced abortions in the United States.

The major surveillance systems in CDC include the Pregnancy Risk Assessment Monitoring System (PRAMS), the Assisted Reproductive Technology system (ART), and the Pregnancy Mortality Surveillance System (PMSS). These systems are done on a routine and continuing basis. Other surveillance analyses are conducted on a less routine basis by analyzing secondary data on such topics as ectopic pregnancy and hysterectomy.

CDC compiles information on hysterectomies by using data from the National Hospital Discharge Survey. This survey, which collects data on discharges from U.S. hospitals, provides population-based estimates of U.S. hysterectomy rates. Data from national hysterectomy surveillance can be used to increase understanding of the relative public health importance of the conditions that lead to hysterectomy, identify changes in clinical practice, and assist in setting biomedical research priorities.

The role of surveillance has been expanded over the past year to include public health informatics. Public health informatics is being used to conduct more careful evaluations of surveillance systems in place, and those yet to be developed, in terms of efficiency and output. Public health informatics is a new scientific field combining the technical knowledge of information systems with the need to analyze data for decision making. By weaving in the use of informatics with surveillance, reproductive health surveillance will be evolving in the coming years to address more complex health issues and conditions.

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Page last reviewed: 7/28/08
Page last modified: 2/07/07
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion