At A Glance
Noteworthy Characteristics
- Provides estimates on a variety of maternal and infant health indicators that are not available from any other data source such as infant sleep practices, unintended births, and patterns of health insurance coverage before, during, and after pregnancy.
- Optional questions (standard questions added to the core PRAMS questions used by all states) cover different topics (e.g., diet, physical activity) in select states and years.
- Can be used to examine the associations between risk factors and outcomes, explore disparities by subpopulations, and compare health indicators across states.
Website
Purpose
The Pregnancy Risk Assessment Monitoring System (PRAMS) is a joint research project between state departments of health and the Centers for Disease Control and Prevention, Division of Reproductive Health. Developed in 1987, PRAMS is an ongoing, state-specific, population-based surveillance system designed to identify groups of women and infants at high risk for health problems, to monitor changes in health status, and to measure progress towards goals in improving the health of mothers and infants. PRAMS data are used by researchers to investigate emerging issues in the field of reproductive health and by state and local governments to plan and review programs and policies aimed at reducing health problems among mothers and babies.
Target Population
Mothers who had a recent live birth and their infants.
Conducted
Annually since 1988. Data become available for release approximately 9 months after the end of the calendar year.
Sponsor
Centers for Disease Control and Prevention’s Division of Reproductive Health.
Special Note(s)
Data are available for states and other sites that are vital records jurisdictions including New York City, Washington DC, and Puerto Rico. Because PRAMS is conducted individually by health departments, the questionnaire can vary from state to state.
PRAMS has a minimum overall response rate threshold policy for the release of data. For years 2006 and earlier, this threshold was 70%. Beginning in 2007, the threshold changed to 65% and beginning in 2012 the threshold was changed to 60%. The threshold changed to 55% beginning in 2015. For any given year, the majority, but not all states meet the threshold. For this reason, the number of states with data available may vary from year to year.PRAMS has a minimum overall response rate threshold policy for the release of data. For years 2006 and earlier, this threshold was 70%. Beginning in 2007, the threshold changed to 65% and beginning in 2012 the threshold was changed to 60%. The threshold changed to 55% beginning in 2015. For any given year, the majority, but not all states meet the threshold. For this reason, the number of states with data available may vary from year to year.
Sampling
Sample Design
Cross-sectional survey with a stratified systematic sample drawn from a frame of eligible birth certificates in each participating site.
Source of Information
PRAMS employs a mixed-mode methodology. Selected women are first contacted by mail. If there is no response to repeated mailings, women are contacted and interviewed by telephone. Data collection procedures and instruments are standardized to allow comparisons between states.
The PRAMS questionnaire is available in English and in Spanish; those states with a large Hispanic population may choose to use the Spanish language questionnaire.
Sample Size
The PRAMS sample of women who have had a recent live birth is drawn from the state’s birth certificate file. Each participating state samples between 1,000 and 3,400 women per year. Women from some groups are sampled at a higher rate to ensure adequate data are available in smaller but higher risk populations.
Key Variables
Demographic
| Name | Methods of Assessment |
|---|---|
| Age | Questionnaire |
| Race/ethnicity | Questionnaire |
| Education level | Questionnaire |
| Marital status | Questionnaire |
| Parity | Questionnaire |
| Household income | Questionnaire |
Diet-Related
| Name | Methods of Assessment |
|---|---|
| Breastfeeding (e.g., breastfeeding status, breastfeeding duration, breastfeeding barriers | Questionnaire |
Sleep-Related
| Name | Methods of Assessment |
|---|---|
| Physical sleep environment: Items needed for sleep (e.g., stuffed animal, pacifier) | Interview/Questionnaire with Parent |
| Physical sleep environment: Sleep surface/mattress/bedding comfortability | Interview/Questionnaire with Parent |
| Physical sleep environment: Other | Interview/Questionnaire with Parent |
| Sleep duration and quantity: Total sleep time | Interview/Questionnaire with Parent |
| Sleep-related policies: Housing policies that impact the sleep environment | Interview/Questionnaire with Parent |
| Sleep-related substance use: Medication use (e.g. ADHD, ADD) | Interview/Questionnaire with Parent |
| Social sleep environment: Co-sleeping with infant | Interview/Questionnaire with Parent |
| Social sleep environment: Shared bedroom/bed | Interview/Questionnaire with Parent |
| Social sleep environment: Sleep location (e.g., living room) | Interview/Questionnaire with Parent |
| Social sleep environment: Other | Interview/Questionnaire with Parent |
| Sleep continuity: Number of awakenings | Interview/Questionnaire with Parent |
Weight-Related
| Name | Methods of Assessment |
|---|---|
| Provider discussion about maintaining a healthy weight | Questionnaire |
| Pre-pregnancy BMI | Questionnaire |
| Weight gain during pregnancy | Questionnaire |
| Infant birthweight | Questionnaire |
Other
| Name | Methods of Assessment |
|---|---|
| Pre-existing health conditions | Questionnaire |
| Physician/health professional asking about how much weight to gain during pregnancy | Questionnaire |
| Physician/health professional asking about intent to breastfeed | Questionnaire |
Data Access and Cost
Data Availability
For studies that involve multiple states by submitting a proposal to CDC. Follow the process outlined below.
1. PRAMS Application Form pdf icon[PDF – 247 KB]
2. Project Abstract of 350 words or less.
3. Signed Data Sharing Agreement pdf icon[PDF – 34KB] (including signatures of all authors).
Cost
Free
Special Note(s)
The most recent year for which data are available is not necessarily the most recent year this survey was conducted. Statistical software programs for complex survey designs such as STATA or SUDAAN are needed to analyze PRAMS data.
Geocode/Linkage
Geocode Variable(s)
None
Existing Linkages
None
Selected Publications
General
A list of publications can be found here: https://www.cdc.gov/prams/mmwrs.htm
Methods
https://www.cdc.gov/prams/pdf/methodology/PRAMS-Design-Methodology-508.pdf
Resources
Documentation/Codebook(s)
https://www.cdc.gov/prams/prams-data/docs/PRAMS-Research-Dataset-Codebook_tagged508.pdf
Analytic Guidelines
Provided with analytic dataset.
