Surveillance data have been critical to these efforts. This monograph explores topics of longstanding importance to the health of women, infants, and children. Maternal mortality and morbidity as well as fetal and infant deaths are of continuing concern, along with associated conditions such as infectious diseases, preterm births, and birth defects. In addition, newer issues, such as human immunodeficiency virus infection, injuries, and develop-mental disabilities, indicate the increasing view of public health defined more broadly than in the earlier decades of this century. The study of these indicators can pro-vide fundamental clues to improving the health of women and children.
Several themes illustrate the challenges of the surveillance of women and children's outcomes.
First, surveillance data and epidemiologic studies rarely differentiate among etiologic pathways. Without more detailed information and investigation of causes, the data cannot yield the knowledge needed to design preventive interventions. Second, no indicator has widespread meaning until standard definitions are used, reporting is consistent, and attention is given to data quality. Some key examples include the need for more standardization in fetal death reporting, better reporting of data regarding the last menstrual period to determine gesta-tional age, and improved diagnosis of birth defects. Although CDC can provide definitions and guidance, standardization is needed at the state, local, and clini-cal levels to improve data quality.