Pregnancy Risk Assessment Monitoring Services

Pregnancy Risk Assessment Monitoring Services (PRAMS) is a survey of maternal behaviors and experiences shortly before, during, and shortly after pregnancy.

Goals and Objectives of PRAMS

The overall goal of PRAMS is to reduce infant morbidity and mortality, and maternal morbidity by influencing maternal behaviors during and immediately after pregnancy. Four specific objectives to achieve the PRAMS' goal are:

  • To collect population-based data of high scientific quality
  • To conduct comprehensive analyses
  • To translate results from analyses into information for planning and evaluating public health programs and policies
  • To build state capacity to collect, analyze, and translate data, in order to address relevant public health issues dealing with pregnancy and early infancy

PRAMS offers a free gift to all mothers who complete and return their survey – an heirloom birth certificate/announcement for their baby. This 11" x 14" document is suitable for framing.  

New Hampshire selected topics include:

  • Breastfeeding
  • Testing for Arsenic and Lead in drinking water
  • Text messaging
  • Oral care
  • Marijuana use
  • Social network information sources
  • Work history and leave-time
  • Lyme Disease
  • Discrimination while accessing health care services

What is PRAMS?

PRAMS stands for Pregnancy Risk Assessment Monitoring System. It was launched in 1987 by the Centers for Disease Control and Prevention (CDC) as part of an initiative to reduce infant mortality and low birth weight. PRAMS is a survey that collects state-specific, population-based data on maternal attitudes, behaviors and experiences before, during and after pregnancy.

In New Hampshire, the PRAMS Project resides in the Maternal and Child Health Section of the Division of Public Health Services, within the Department of Health and Human Services. The PRAMS statewide steering committee is comprised of a multi-disciplinary group of professionals from the public and private sectors, as well as from the academic community.

PRAMS is funded through a five-year cooperative agreement with CDC. Forty-nine states and territories as well as New York City and Washington DC currently participate in PRAMS. New Hampshire joined the national effort and began data collection in 2013.

Why is PRAMS Important?

Research has shown that maternal behaviors during pregnancy may influence infant birth weight and mortality rates. PRAMS was designed to supplement state and national Vital Records data; it provides state-specific data on maternal behaviors and experiences, to be used for planning and assessing perinatal health programs, and for describing maternal experiences that may contribute to maternal and infant health.

PRAMS Methodology

In New Hampshire, approximately one of every twelve mothers of newborns is selected for PRAMS. Mothers are randomly chosen from birth records. Women who delivered a low birth weight infant are selected at a higher rate to ensure that adequate data are available in this smaller but higher risk population. Selected women are first contacted by mail approximately two to six months after delivery of their baby. If there is no response to repeated mailings (up to three mailings), women are contacted and interviewed by telephone. Data collection procedures and instruments are standardized in all participating states.

Information Collected by PRAMS

The PRAMS Survey Booklet includes core questions that are asked by all participating states, as well as state-specific questions that are chosen or developed by individual states. The core portion of the survey includes questions about the following:

  • Attitudes and feelings about the most recent pregnancy
  • Barriers to and content of prenatal care
  • Induction of labor
  • Use of alcohol and tobacco before and during pregnancy
  • Smoking cessation
  • Flu vaccination
  • Awareness of benefits of folic acid
  • Pregnancy-related violence or abuse
  • Infant safety, sleep position, and exposure to tobacco smoke
  • Depression and Stressors

Use of PRAMS Data

New Hampshire PRAMS provides data not available from other sources about pregnancy and early infancy. Findings from analyses of PRAMS population-based data can be generalized to New Hampshire's entire population of women who delivered a live-born infant. The same data collection methods are used in all PRAMS states, so New Hampshire data can be compared with other participating states. PRAMS data will be used in the following ways:

  • To identify groups of women and infants at high risk for health problems
  • To monitor changes in health status
  • To measure progress toward goals in improving the health of mothers and infants

New Hampshire PRAMS data will be used by the State of New Hampshire to plan and review programs and policies aimed at reducing health problems among mothers and babies. The data will also be shared with other state and local agencies that have important contributions to make in planning maternal and infant health programs and to develop partnerships with those agencies.

Researchers can request NH PRAMS data by submitting a Data Request.