Am J Perinatol 2020; 37(10): 982-990
DOI: 10.1055/s-0040-1712104
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Framework for Coordination between Obstetric and Pediatric Providers in Public Health Emergencies: Lessons Learned from the Zika Outbreak in the United States, 2015 to 2017

Rebecca T. Leeb
1  National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Robyn A. Cree
1  National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Laura Aird
2  Emerging Threats and Disaster Management, Pediatric Population Health, Department of Healthy Resilient Children, Youth and Families, American Academy of Pediatrics, Itasca, Illinois
Roberta L. DeBiasi
3  Division of Pediatric Infectious Diseases, Children’s National Hospital/Children’s National Research Institute, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
Rita W. Driggers
4  Johns Hopkins University School of Medicine, Sibley Memorial Hospital, Johns Hopkins Medicine, Washington, District of Columbia
Elizabeth Garbarczyk
5  Division of State Coverage Programs, Center for Medicaid & CHIP Services, Centers for Medicare and Medicaid Services, Baltimore, Maryland
Lynne M. Mofenson
6  Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia
Scott Needle
7  Elica Health Centers, Sacramento, California
Jeannie Rodriguez
8  National Association of Pediatric Nurse Practitioners, New York, New York
9  Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia
Christine Curry
10  University of Miami, Miller School of Medicine, Miami, Florida
Francisco García
11  Community and Heath Services, Pima County, Tucson, Arizona
Shana Godfred-Cato
1  National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Debra Hawks
12  Practice Activities, Obstetrics and Immunization, American College of Obstetricians and Gynecologists, Washington, District of Columbia
Elizabeth Rosenblum
13  Department of Family Medicine & Public Health, Universtiy of California San Diego, San Diego, California
Eric Dziuban
14  Center for Global Health, Centers for Disease Prevention and Control, Windhoek, Namibia
Mark Hudak
15  Department of Pediatrics, University of Florida College of Medicine–Jacksonville, Jacksonville, Florida
› Author Affiliations
Further Information

Publication History

23 January 2020

24 April 2020

Publication Date:
21 May 2020 (online)


Emergency response to emerging threats with the potential for vertical transmission, such as the 2015 to 2017 response to Zika virus, presents unique clinical challenges that underscore the need for better communication and care coordination between obstetric and pediatric providers to promote optimal health for women and infants. Published guidelines for routine maternal-infant care during the perinatal period, and models for transitions of care in various health care settings are available, but no broad framework has addressed coordinated multidisciplinary care of the maternal-infant dyad during emergency response. We present a novel framework and strategies to improve care coordination and communication during an emergency response. The proposed framework includes (1) identification and collection of critical information to inform care, (2) key health care touchpoints for the maternal-infant dyad, and (3) primary pathways of communication and modes of transfer across touchpoints, as well as practical strategies. This framework and associated strategies can be modified to address the care coordination needs of pregnant women and their infants with possible exposure to other emerging infectious and noninfectious congenital threats that may require long-term, multidisciplinary management.

Key Points

  • Emerging congential threats present unique coordination challenges for obstetric and pediatric clinicians during emergency response.

  • We present a framework to help coodinate care of pregnant women/infants exposed to congenital threats.

  • The framework identifies critical information to inform care, health care touchpoints, and communication/information transfer pathways.


The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of Centers for Disease Control and Prevention.

Supplementary Material