Pregnancy Risk Assessment Monitoring System (PRAMS)
The Pregnancy Risk Assessment Monitoring System (PRAMS) is a 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.
PRAMS uses a combination of data collection approaches: we contact sampled mothers by mail and follow up by telephone with an online option. Survey responses are linked with the birth certificate data to provide key demographic and clinical information.
PRAMS at-a-glance
PRAMS provides a method for the collection and analysis of perinatal data to better understand maternal health and behaviors before, during, and after pregnancy. PRAMS data assist in evaluating and improving services to women and infants to improve care and prevent poor pregnancy outcomes.
PRAMS in Colorado
In September 1996, we were awarded a grant from the Centers for Disease Control and Prevention to establish PRAMS in Colorado, and data collection began in the spring 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. PRAMS data assist Colorado in evaluating and improving services to women and infants so that poor pregnancy outcomes can be prevented.
The PRAMS questionnaire is mailed to a sample of Colorado women each month. Participants complete the surveys and return them to us, and 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.
Population presented
PRAMS uses Colorado birth certificate data to draw a random sample each month from within geographic regions (stratified random sampling), which allows the program to increase representation of rural birthing people. To make the estimates representative of all live births in Colorado, statistical weighting is applied to account for the sample design and for those who do not respond. The final weighted dataset represents the population of all live births to Colorado residents only. Nonresidents are excluded from the sample to ensure that the estimates reflect births to Colorado residents only.
Health topic areas covered
- Preconception care and health.
- Attitudes and feelings about pregnancy.
- Prenatal care experiences.
- Health insurance coverage.
- Breastfeeding initiation, duration, and support.
- Alcohol, tobacco, and marijuana use.
- Infant health.
- Mental health, psychosocial support, and stress.
- Maternal morbidity.
- Oral health care during pregnancy.
- Immunizations.
- Postpartum care.
- Experiences of discrimination.
Health disparities/inequities
Data analyses of health measures that stratify by or otherwise consider demographic variables (e.g., race/ethnicity, age, sex, socioeconomic position) can be used to assess health disparities and inequities.
PRAMS data
Phase 9:
Phase 8:
- Findings from the 2022 PRAMS summary tables.
- Findings from the 2021 PRAMS summary tables.
- Findings from the 2020 PRAMS summary tables.
- Findings from the 2019 PRAMS summary tables.
- Findings from the 2018 PRAMS summary tables.
- Findings from the 2017 PRAMS summary tables.
- Findings from the 2016 PRAMS summary tables.
Data collection and analysis
Findings from data analysis are distributed to local health departments, state legislators, professional societies, voluntary agencies, health care organizations, and universities.
Methodology
PRAMS is a survey administered at 2-4 months postpartum. Respondents can complete the survey in English or Spanish by mail, web, or phone.
Survey instrument
The questionnaire has two parts: core questions asked by all states and additional questions chosen from a pretested list of standard questions developed by CDC or developed by states on their own.
Sample selection
The sample is based on all Colorado residents ages 15 and older who had a live birth. Non-residents who gave birth in Colorado and parents who had multiple gestation infants (4 or more) are excluded from the sample.
Sample size
Just over 2,000 postpartum women are sampled and approximately 1,100 respondents complete the PRAMS survey each year.
Granularity
Aggregate data are available at the state and region levels, and may be available at the county level for more populous counties.
Data availability
PRAMS data are released annually, typically in the winter.
Considerations for interpretation
- PRAMS data are weighted to be representative of all live births in Colorado.
- Data are based on self-report, which may lead to under- or overreporting of health behaviors and conditions.
PRAMS follows a rule of not reporting or interpreting percentages from questions whose unweighted number of valid responses is fewer than 30.
Questionnaires cycle through new phases every three to five years. Questions may change from phase to phase, and not all questions are asked in each phase
Related maternal and child health programs and data
Contact Colorado PRAMS
Health Statistics and Evaluation Branch,
HSVR-HS-A1
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, CO 80246-1530
Phone: 303-692-2160
The PRAMS Project is funded under grant No. 5 U01DP006625 from the U.S. Centers for Disease Control and Prevention.