Pregnancy Risk Assessment Monitoring System (PRAMS)

Definitions of indicators

Infant Health

Indicator Question Possible Responses Data Collection Period Definition
Breastfeeding initiation Did you ever breastfeed or pump
breast milk to feed your baby?
  • No
  • Yes
2000-2011 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those whose babies have died or are not living with them.
Breastfeeding four weeks or more How many weeks or months did you
breastfeed or pump milk to feed your baby?
  • ____weeks
  • ____months
  • Less than one week
2000-2011 Numerator: Respondents who breastfed for four weeks or more.

Denominator: All respondents, excluding those whose babies have died or are not living with them.
Breastfeeding eight weeks or more How many weeks or months did you
breastfeed or pump milk to feed your baby?
  • ____weeks
  • ____months
  • Less than one week
2000-2011 Numerator: Respondents who breastfed for eight weeks or more.

Denominator: All respondents, excluding those whose babies have died or are not living with them.
Infants placed on back to sleep In which one position do you
most often lay your baby down to sleep now?
  • On his or her side
  • On his or her back
  • On his or her stomach
2000-2011 Numerator: Respondents who checked "On his or her back".

Denominator: All respondents, excluding those whose babies have died or are not living with them.

Oral Health

Indicator Question Possible Responses Data Collection Period Definition
Ever had teeth cleaned Have you ever had your teeth cleaned by a dentist or dental hygienist?
  • No
  • Yes
2004-2011 Numerator: Respondents who checked "Yes"

Denominator: All respondents.
Teeth cleaned during pregnancy When did you have your teeth cleaned by a dentist or dental hygienist?
  • Before my most recent pregnancy
  • During my most recent pregnancy
  • After my most recent pregnancy
2004-2011 Numerator: Respondents who checked "during my most recent pregnancy."

Denominator: All respondents.
Needed to see a dentist for a problem during pregnancy This question is about the care of your teeth and gums during your most recent pregnancy
  • I needed to see a dentist for a problem
  • I went to a dentist or a dental clinic
  • A dental or other health care worker talked to me about how to care for my teeth and gums
2002-2011 Numerator: Respondents who checked "I needed to see a dentist for a problem."

Denominator: All respondents.
Went to a dentist or dental clinic during pregnancy This question is about the care of your teeth and gums during your most recent pregnancy
  • I needed to see a dentist for a problem
  • I went to a dentist or a dental clinic
  • A dental or other health care worker talked to me about how to care for my teeth and gums
2002-2011 Numerator: Respondents who checked "I went to a dentist or dental clinic."

Denominator: All respondents.
Talked to a dentist or health care worker about care of teeth and gums during pregnancy This question is about the care of your teeth and gums during your most recent pregnancy
  • I needed to see a dentist for a problem
  • I went to a dentist or a dental clinic
  • A dental or other health care worker talked to me about how to care for my teeth and gums
2002-2011 Numerator: Respondents who checked "A dental or other health care worker talked to me about how to care for my teeth and gums. "

Denominator: All respondents.

Nutrition

Indicator Question Possible Responses Data Collection Period Definition
Multivitamin use before pregnancy During the month before you got pregnant with your new baby, how many times a week did you take a multivitamin or a prenatal vitamin?
  • I didn't take a multivitamin or prenatal vitamin at all
  • 1 to 3 days a week
  • 4 to 6 days a week
  • Every day of the week
2000-2011 Numerator: Respondents who checked "1 to 3 days a week" or "4 to 6 days a week" or "everyday of the week."

Denominator: All respondents.
Folic acid knowledge Some health experts recommend taking folic acid for which one of the following reasons?
  • To make strong bones
  • To prevent birth defects
  • To prevent high blood pressure
  • I don't know
2000-2011 Numerator: Respondents who checked "To prevent birth defects."

Denominator: All respondents.
WIC services during pregnancy During your most recent pregnancy were you on WIC (the Special Supplemental Nutrition Program for Women, Infants, and Children)?
  • No
  • Yes
2000-2011 Numerator: Respondents who checked "Yes."

Denominator: All respondents.

Maternal Behaviors

Indicator Question Possible Responses Data Collection Period Definition
Smoking before pregnancy In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day?
  • 41 cigarettes or more
  • 21 to 40 cigarettes
  • 11 to 20 cigarettes
  • 6 to 10 cigarettes
  • 1 to 5 cigarettes
  • Less than 1 cigarette
  • None (0) cigarettes
2000-2011 Numerator: Respondents who reported smoking any cigarettes.

Denominator: All respondents, excluding those who have not smoked in the last 2 years.
Smoking during pregnancy In the last three months of pregnancy, how many cigarettes did you smoke on an average day?
  • 41 cigarettes or more
  • 21 to 40 cigarettes
  • 11 to 20 cigarettes
  • 6 to 10 cigarettes
  • 1 to 5 cigarettes
  • Less than 1 cigarette
  • None (0) cigarettes
2000-2011 Numerator: Respondents who reported smoking any cigarettes.

Denominator: All respondents, excluding those who have not smoked in the last 2 years.
Smoking after delivery How many cigarettes do you smoke on an average day now?
  • 41 cigarettes or more
  • 21 to 40 cigarettes
  • 11 to 20 cigarettes
  • 6 to 10 cigarettes
  • 1 to 5 cigarettes
  • Less than 1 cigarette
  • None (0) cigarettes
2000-2011 Numerator: Respondents who reported smoking any cigarettes.

Denominator: All respondents, excluding those who have not smoked in the last 2 years.
Drinking before pregnancy During the 3 months before you got pregnant, how many alcoholic drinks did you have in an average week?
  • 14 drinks or more a week
  • 7 to 13 drinks a week
  • 4 to 6 drinks a week
  • 1 to 3 drinks a week
  • Less than 1 drink a week
  • I didn't drink then
2004-2011 Numerator: Respondents who reported having any alcoholic drinks.

Denominator: All respondents, excluding those who have not had any alcohol in the last 2 years.
Drinking during pregnancy During the last 3 months of your pregnancy, how many alcoholic drinks did you have in an average week?
  • 14 drinks or more a week
  • 7 to 13 drinks a week
  • 4 to 6 drinks a week
  • 1 to 3 drinks a week
  • Less than 1 drink a week
  • I didn't drink then
2004-2011 Numerator: Respondents who reported having any alcoholic drinks.

Denominator: All respondents, excluding those who have not had any alcohol in the last 2 years.

Family Planning

Indicator Question Possible Responses Data Collection Period Definition
Women who were trying to become pregnant When you got pregnant with your new baby, were you trying to get pregnant?
  • No
  • Yes
2000-2011 Numerator: Respondents who checked "Yes."

Denominator: All respondents.
Fertility treatments received for most recent pregnancy Did you receive treatment from a doctor, nurse, or other health care worker to help you get pregnant with your new baby?
  • No
  • Yes
2004-2011 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who were not trying to get pregnant, and those using birth control to prevent pregnancy.
Women who were using birth control when they became pregnant When you got pregnant with your new baby, were you or your husband or partner doing anything to keep from getting pregnant?
  • No
  • Yes
2000-2011 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who were trying to get pregnant.
Live births resulting from an unintended pregnancy Thinking back to just before you became pregnant with your new baby, how did you feel about becoming pregnant?
  • I wanted to be pregnant sooner
  • I wanted to be pregnant later
  • I wanted to be pregnant then
  • I didn't want to be pregnant then or at any time in the future
2000-2011 Numerator: Respondents who checked "I wanted to be pregnant later" or "I didn't want to be pregnant then or at any time in the future."

Denominator: All respondents.

Prenatal and Postpartum Care

Indicator Question Possible Responses Data Collection Period Definition
Prenatal care counseling on smoking during pregnancy During any of your prenatal care visits, did a doctor, nurse, or other health care worker talk with you about any of the things listed below?
  • How smoking during pregnancy could affect my baby
  • Breastfeeding my baby
  • How drinking alcohol during pregnancy could affect my baby
  • Using a seatbelt during my pregnancy
  • Birth control methods to use after my pregnancy
  • Medicines that are safe to take during my pregnancy
  • How using illegal drugs could affect my baby
  • Doing tests to screen for birth defects or diseases that run in my family
  • What to do if my labor starts early
  • Getting tested for HIV (the virus that causes AIDS)
  • Physical abuse to women by their husbands or partners
2000-2011 Numerator: Respondents who checked "How smoking during pregnancy could affect my baby."

Denominator: All respondents, excluding those who did not go for prenatal care.
Prenatal care counseling on alcohol use during pregnancy During any of your prenatal care visits, did a doctor, nurse, or other health care worker talk with you about any of the things listed below?
  • How smoking during pregnancy could affect my baby
  • Breastfeeding my baby
  • How drinking alcohol during pregnancy could affect my baby
  • Using a seatbelt during my pregnancy
  • Birth control methods to use after my pregnancy
  • Medicines that are safe to take during my pregnancy
  • How using illegal drugs could affect my baby
  • Doing tests to screen for birth defects or diseases that run in my family
  • What to do if my labor starts early
  • Getting tested for HIV (the virus that causes AIDS)
  • Physical abuse to women by their husbands or partners
2000-2011 Numerator: Respondents who checked "How drinking alcohol during pregnancy could affect my baby."

Denominator: All respondents, excluding those who did not go for prenatal care.
Prenatal care counseling on HIV testing during pregnancy During any of your prenatal care visits, did a doctor, nurse, or other health care worker talk with you about any of the things listed below?
  • How smoking during pregnancy could affect my baby
  • Breastfeeding my baby
  • How drinking alcohol during pregnancy could affect my baby
  • Using a seatbelt during my pregnancy
  • Birth control methods to use after my pregnancy
  • Medicines that are safe to take during my pregnancy
  • How using illegal drugs could affect my baby
  • Doing tests to screen for birth defects or diseases that run in my family
  • What to do if my labor starts early
  • Getting tested for HIV (the virus that causes AIDS)
  • Physical abuse to women by their husbands or partners
2000-2011 Numerator: Respondents who checked "Getting tested for HIV (the virus that causes AIDS)."

Denominator: All respondents, excluding those who did not go for prenatal care.
HIV test during pregnancy At any time during your most recent pregnancy or delivery, did you have a test for HIV (the virus that causes AIDS)?
  • No
  • Yes
2000-2011 Numerator: Respondents who checked "Yes."

Denominator: All respondents.
Prenatal care received from doctor's office or HMO clinic Where did you go most of the time for your prenatal care visits?
  • Hospital clinic
  • Health Department Clinic
  • Private doctor's office or HMO clinic
  • Community Health Center
  • Other________
2000-2011 Numerator: Respondents who checked "Private doctor's office or HMO clinic."

Denominator: All respondents, excluding those who did not go for prenatal care.
Mother received postpartum checkup Since your new baby was born, have you had a postpartum checkup for yourself?
  • No
  • Yes
2004-2011 Numerator: Respondents who checked "Yes"

Denominator: All respondents.

Mental and Physical Well-being

Indicator Question Possible Responses Data Collection Period Definition
Poor mental health status during pregnancy How would you describe the time during your most recent pregnancy?
  • One of the happiest times of my life
  • A happy time with few problems
  • A moderately hard time
  • A very hard time
  • One of the worst times of my life
2000-2011 Numerator: Respondents who checked "A very hard time" or "One of the worst times of my life."

Denominator: All respondents.
Physical abuse before pregnancy During the 12 months before you got pregnant with your new baby, did your husband or partner push, hit, slap, kick, choke, or physically hurt you in any other way?
  • No
  • Yes
2000-2011 Numerator: Respondents who checked "Yes"

Denominator: All respondents.
Physical abuse during pregnancy During your most recent pregnancy, did your husband or partner push, hit, slap, kick, choke, or physically hurt you in any other way?
  • No
  • Yes
2000-2011 Numerator: Respondents who checked "Yes"

Denominator: All respondents.