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Pregnancy Risk Assessment Monitoring System (PRAMS)

While the United States infant mortality rate is declining, it still remains higher than rates in other developed countries. The low birth weight rate for the nation has increased in recent years to a level higher than that of 15 years ago. Studies indicate that maternal behaviors such as smoking, drug and alcohol abuse, and limited use of prenatal care may be inhibiting further declines in these rates. PRAMS (Pregnancy Risk Assessment Monitoring System) is a population-based risk factor surveillance system designed to identify and monitor behaviors and experiences of women before, during, and after pregnancy. Information is collected by surveying a sample of women who have recently given birth. Findings from the PRAMS survey are used to develop and assess perinatal health programs in public and private health care settings.

To help state health departments establish and maintain a surveillance system of selected maternal behaviors, the Centers for Disease Control and Prevention (CDC) collaborated with several states to initiate PRAMS in 1987. This surveillance system was developed to supplement vital records data and to generate state-specific data about perinatal health. Currently, there are 37 states participating in the PRAMS project. While each state's project is slightly different, data collection procedures and instruments are standardized to permit comparisons of data among the PRAMS states. For more information about PRAMS projects in these states please contact the CDC at http://www.cdc.gov/PRAMS/states.htm

PRAMS in Colorado

In September of 1996, the Colorado Department of Public Health and Environment was awarded a grant from CDC to establish PRAMS in Colorado, and data collection began in the spring of 1997.

Colorado continues to have one of the highest low birth weight rates in the nation for total births and for births in all major racial and ethnic groups. PRAMS provides a method for the collection and analysis of perinatal data to better understand not only low birth weight rates, but also maternal behaviors, access to prenatal care, pregnancy intendedness, and health care delivery to women and infants in Colorado. Ultimately, PRAMS data can assist Colorado in evaluating and improving services to women and infants so that poor pregnancy outcomes can be prevented.

Within state health departments, PRAMS crosses several organizational units. The Colorado PRAMS Team includes individuals from the Women's Health Section and the Health Statistics Section of the Colorado Department of Public Health and Environment. The Colorado PRAMS Advisory Committee consists of individuals representing the many agencies and organizations in Colorado interested in perinatal and infant health issues. This group meets twice a year to provide feedback and support to the Colorado PRAMS Team.

PRAMS Survey Topics

The PRAMS questionnaire is mailed to a sample of Colorado women each month. Participants complete the surveys and return them to the health department where all answers are grouped to provide data for the entire state. The core set of questions and the questions developed specifically for Colorado collect information on many topics, including:

• attitudes and feelings about pregnancy
• prenatal care and barriers to care
• obstetric history
• psychosocial support and stress
• alcohol and tobacco use
• pregnancy-related morbidity
• infant health care
• economic status of the mother
• home safety and injury prevention
• health care coverage during pregnancy and delivery

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PRAMS Data Collection and Analysis

PRAMS uses a combination of two data collection approaches: statewide mailings of the surveys and telephone follow-up with women who do not return the survey by mail. The written questionnaires and telephone interviews can both be completed in Spanish when necessary. Approximately 240 women in Colorado will receive the survey each month, with an expected response rate of at least 70 percent.

Data collected from women who gave birth in a given year are generally available for analysis and dissemination by late summer of the following year. Findings from data analysis are distributed to local health departments, state legislators, professional societies, voluntary agencies, health care organizations, universities, and other interested persons.

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Information about Colorado PRAMS

Additional information about Colorado PRAMS can be obtained from:

Health Statistics Section, HSVR-HS-A1
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, CO 80246-1530
Telephone: (303) 692-2160

Women's Health Section, FCHSD-WH-A4
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, CO 80246-1530
Telephone: (303) 692-2480

Colorado PRAMS e-mail: prams.comments@state.co.us

The PRAMS Project is funded under grant number U50-CCU-813490-01 from the Centers for Disease Control and Prevention.

Colorado Department of Public Health and Environment
Health Statistics
CHEIS-HS-A1
4300 Cherry Creek Drive South
Denver, CO 80246-1530

FAX: (303)691-7821
Tel. #: (303)692-2160  
E-mail:  health.statistics@state.co.us

Go to PRAMS Data

Publications

   Health Watch No 70
Maternal Indicators for Women on Medicaid in Colorado: An Analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) Survey Data  

    Health Watch No. 51:
Weight Gain During Pregnancy: Colorado Pregnancy Risk Assessment Monitoring System (PRAMS), 1997-2000

    Health Watch No. 43:
Unintended Pregnancy: Colorado Pregnancy Risk Assessment Monitoring System (PRAMS), 1997-1999

    PRAMS
searchable database on CoHID