Pregnancy Risk Assessment Monitoring System (PRAMS)

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What is New York State PRAMS?

New York State PRAMS is an ongoing mail/telephone survey of mothers who have recently given birth to a live born infant. PRAMS collects information from mothers about behaviors and experiences before, during and after pregnancy to learn more about how to reduce infant deaths and low birth weight births. The PRAMS project was developed by the Centers for Disease Control and Prevention (CDC) in 1987 because infant mortality rates were no longer declining as rapidly as they had in prior years. In addition, the incidence of low birth weight infants had changed little over the previous 20 years. Research has indicated that maternal behaviors and experiences during pregnancy may influence infant birth weight and mortality rates. Information collected from PRAMS is not available from other sources and provides data on smoking during pregnancy, oral health care, vaccines during pregnancy, nutrition, domestic violence, psychosocial stress, HIV testing, sexually transmitted diseases, breastfeeding and family planning. The goal of the PRAMS project is to improve the health of mothers and infants by reducing adverse outcomes such as low birth weight, infant mortality and morbidity, and maternal morbidity. PRAMS provides state-specific data for planning and assessing health programs and for describing maternal experiences that may contribute to maternal and infant health.

New York State PRAMS does not include information on New York City births since the New York City Department of Health and Mental Hygiene conducts their own PRAMS.

What information does PRAMS collect?

The PRAMS questionnaire includes core questions that are asked by all participating states as well state-specific questions that target health indicators that are important to New York State, excluding NYC. Core topics include:

  • Pregnancy intention
  • Barriers to and content of prenatal care
  • Maternal health behaviors
  • Nutrition
  • Infant health care
  • Psychological support and stressful life events

Topics specific to New York State include the following:

  • Oral health
  • Fertility treatments
  • Breastfeeding support
  • Family planning
  • Infant health
  • Sexually transmitted diseases (STD's)
  • Postpartum depression

Questionnaires

The PRAMS questionnaire is revised periodically. With each revison (or new phase of the questionnaire), some of the questions change. The years covered by the different phases are listed below:

How are PRAMS data collected?

Approximately 135 mothers are randomly selected from birth records each month. Low birth weight births are sampled at a higher rate to ensure adequate representation. The selected mothers are sampled between two and four months after giving birth. Mothers are sent questionnaires asking about their pregnancies and the time immediately after the birth of their babies. Questionnaire packets include a cover letter, question and answer sheet, a consent document, and a music CD as an incentive. If a mother does not respond after three questionnaires are sent, attempts to reach her by phone are made. Mothers are offered a $10 CVS gift card as a reward if they send back the mailed questionaire. Women contacted by phone are offered a $20 CVS gift card if they complete the survey over the phone. Data collection procedures and instruments are standardized to allow comparisons between states.

Why is PRAMS important?

Research has shown that maternal behavior and experiences during pregnancy may influence infant birth weight and mortality rates. The PRAMS questionnaire provides data that are not available from other sources about pregnancy and the first few months after birth. These data can be used 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 for improving the health of mothers and infants. When combined with data from birth certificates, these data can be used for planning and assessing perinatal health programs. In addition, because PRAMS uses standardized data collection methods, it allows data to be compared among states.

PRAMS Data and Statistics

  • PRAMS Reports

    Selected PRAMS indicators are available by year of birth and are presented by maternal demographics. Maternal demographics include age, race, education, marital status and Medicaid status. Trend plots are also presented for selected indicators for the years 2000-2008. Please see PRAMS sampling and analysis methodology for specific details.

  • PRAMS Data Available to Researchers

    Researchers may request the PRAMS Analytic Research File for studies that involve multiple states by submitting a proposal to CDC. The submission process is outlined on the CDC PRAMS website.

Who uses New York State PRAMS?

PRAMS data are used by researchers to investigate emerging issues in the field of maternal and child health and by state and local governments to plan and review programs and policies aimed at reducing health problems among mothers and babies. The New York State Department of Health uses PRAMS data for planning and evaluation of perinatal health programs. The PRAMS team works with the Maternal and Child Health Services Block Grant Advisory Council that consists of a multi-disciplinary group of individuals from the public and private sector as well as the academic community. The group provides expertise to the PRAMS team to assure that data collected in the survey are useful for analyzing important maternal and child health related issues.

Who are the partners in PRAMS?

New York State PRAMS is funded through a cooperative grant agreement with CDC and state funds. Thirty-seven states, and New York City currently participate in PRAMS. Nationally, PRAMS surveillance currently covers about 75% of all U.S. births.