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
2000-2012 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
2000-2012 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
2000-2012 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
2009-2012 Numerator: Respondents who checked "On his or her back".

Denominator: All respondents, excluding those whose babies have died or are not living with them.
Co-sleeping with infant Listed below are some things that describe how your new baby usually sleeps:
  • h. My new baby sleeps with me or another person
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "My new baby sleeps with me or another person".

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

Hospital Practices Related to Breastfeeding

Indicator Question Possible Responses Data Collection Period Definition
Hospital gave breastfeeding info This question asks about things that may have
happened at the hospital where your new baby was born:
  • a. Hospital staff gave me information about breastfeeding
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Baby stayed in same room in hospital This question asks about things that may have
happened at the hospital where your new baby was born:
  • b. My baby stayed in the same room with me at the hospital
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Mother breastfed baby first hour after birth This question asks about things that may have
happened at the hospital where your new baby was born:
  • d. I breastfed in the first hour after my baby was born
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Hospital helped mother learn how to breastfeed This question asks about things that may have
happened at the hospital where your new baby was born:
  • f. My baby was fed only breastmilk in the hospital
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Hospital helped mother learn how to breastfeed This question asks about things that may have
happened at the hospital where your new baby was born:
  • g. Hospital staff told me to breastfeed whenever my baby wanted
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Baby fed only breastmilk in the hospital This question asks about things that may have
happened at the hospital where your new baby was born:
  • f. My baby was fed only breast milk at the hospital
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Hospital told mother to breastfeed on demand This question asks about things that may have
happened at the hospital where your new baby was born:
  • g. Hospital staff told me to breastfeed whenever my baby wanted
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Hospital gave mother breastpump This question asks about things that may have
happened at the hospital where your new baby was born:
  • h. The hospital staff gave me a breastpump to use
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Mother given gift pack with formula This question asks about things that may have
happened at the hospital where your new baby was born:
  • i. The hospital gave me a gift pack with formula
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Hospital gave mother telephone number for help with breastfeeding This question asks about things that may have
happened at the hospital where your new baby was born:
  • j. The hospital gave me a telephone number to call for help with breastfeeding
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.
Baby used pacifier in hospital This question asks about things that may have happened at the hospital where your new baby was born:
  • k. Hospital staff gave my baby a pacifier
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents, excluding those who did not breastfeed.

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 Did you have your teeth cleaned by a dentist or dental hygienist during the time periods listed below?
  • During my most recent pregnancy
  • After my most recent pregnancy
2009-2011 Numerator: Respondents who checked "during my most recent pregnancy."

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
2004-2008 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
2002-2012 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
2002-2012 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
2002-2012 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
2000-2012 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
2000-2012 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
2000-2012 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
2000-2012 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
2000-2012 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
2000-2012 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
2004-2012 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
2004-2012 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
2000-2012 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
2004-2012 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
2000-2012 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
2000-2012 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.
Women using birth control after delivery Are you or your husband or partner doing anything now to keep from getting pregnant?
  • No
  • Yes
2000-2012 Numerator: Respondents who checked "Yes."

Denominator: All respondents

Preconception Health

Indicator Question Possible Responses Data Collection Period Definition
Checked for diabetes before pregnancy At any time during the 12 months before you got pregnant with your new baby did you do any of the following things?
  • d. I visited a health care worker and was checked for diabetes
  • No
  • Yes
2000-2012 Numerator: Respondents who checked "I visited a health care worker and was checked for diabetes."

Denominator: All respondents.
Checked for high blood pressure before pregnancy At any time during the 12 months before you got pregnant with your new baby did you do any of the following things?
  • I visited a health care worker and was checked for depression or anxiety
  • No
  • Yes
2000-2012 Numerator: Respondents who checked "I visited a health care worker and was checked for high blood pressure."

Denominator: All respondents.
Discussed family medical history with health care worker before pregnancy At any time during the 12 months before you got pregnant with your new baby did you do any of the following things?
  • g. I talked to a health care worker about my family medical history
  • No
  • Yes
2000-2012 Numerator: Respondents who checked "I talked to a health care worker about my family medical history."

Denominator: All respondents.
Diagnosed with diabetes before pregnancy Before you got pregnant with your new baby, did a doctor, nurse, or other health care worker tell you that you had any of the following things?
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes."

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?
  • b. How smoking during pregnancy could affect my baby
  • No
  • Yes
2009-2012 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 drinking alcohol during pregnancy could affect my baby
  • No
  • Yes
2009-2012 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?
  • j. Getting tested for HIV (the virus that causes AIDS)
  • No
  • Yes
2009-2012 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.
Prenatal care counseling on preterm labor 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?
  • i. The signs and symptoms of preterm labor
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "What to do if my labor starts early."

Denominator: All respondents, excluding those who did not go for prenatal care.
Prenatal care counseling about breastfeeding 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?
  • Breastfeeding my baby
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Breastfeeding my baby."

Denominator: All respondents, excluding those who did not go for prenatal care.
Prenatal care counseling about depression 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?
  • k. What to do if I feel depressed during my pregnancy or after my baby is born
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "What to do if I feel depressed during my pregnancy or after my baby is born."

Denominator: All respondents, excluding those who did not go for prenatal care.
Prenatal care counseling about abuse 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?
  • Physical abuse to women by their husbands or partners
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Physical abuse to women by their husbands or partners."

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
2000-2012 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
2004-2012 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
2000-2012 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
2000-2012 Numerator: Respondents who checked "Yes"

Denominator: All respondents.
Experienced emotional stress in 12 months before pregnancy This question asks about things that may have
happened during the 12 months before your baby was born.
  • a. A close family member was very sick and had to go into the hospital
  • n. Someone very close to me died
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes".

Denominator: All respondents.
Experienced partner related stress in 12 months before pregnancy This question asks about things that may have
happened during the 12 months before your baby was born.
  • b. I got seperated or divorced from my husband or partner
  • i. I argued with my husband or partner more than usual
  • j. My husband or partner said he didn't want me to be pregnant
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes".

Denominator: All respondents.
Experienced financial stress in 12 months before pregnancy This question asks about things that may have
happened during the 12 months before your baby was born.
  • c. I moved to a new address
  • d. I was homeless or had to sleep outside, in a car, or in a shelter
  • e. My husband or partner lost his job
  • f. I lost my job even though I wanted to go on working
  • k. I had problems paying the rent, mortgage, or other bills
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes".

Denominator: All respondents.
Experienced traumatic stress in 12 months before pregnancy This question asks about things that may have
happened during the 12 months before your baby was born.
  • d. I was homeless or had to sleep outside, in a car, or in a shelter
  • l. My husband, partner or I went to jail
  • m. Someone very close to me had a problem with drinking or drugs
  • No
  • Yes
2009-2012 Numerator: Respondents who checked "Yes".

Denominator: All respondents.