Findings from the Pregnancy Risk Assessment Monitoring System PRAMS, 19931999

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Findings from the Pregnancy Risk Assessment
Monitoring System (PRAMS), 1993-1999

• Laurie F. Beck, Christopher H. Johnson, Brian
  Morrow, Leslie E. Lipscomb, Brenda Colley
  Gilbert, Mary E. Gaffield, Mary Rogers, Nedra
  Whitehead

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Acknowledgments -The PRAMS Working Group

• AL - Rhonda Stephens AK - Kathy Perham-Hester
  AR - Gina Redford CO - Darci Cherry DE - Tony
  Ruggiero FL - Curt Miller
• GA - Tonya Johnson HI - Althea Momi Kamau IL -
  Bruce Steiner LA - Jean Wightkin ME - Martha
  Henson MD - Diana Cheng MI - Yasmina Bouraoui
  MN - Cynthia Turnure MS - Linda Pendleton MT -
  Jo Ann Walsh NE - Debbi Barnes-Josiah NJ -
  Lakota Kruse NM - Ssu Weng

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The PRAMS Working Group(cont)

• NY - Ann Radigan-Garcia NYC - Fabienne Laraque
  NC - Paul Buescher ND - Sandra Anseth OH -
  Adriana Pust OK - Dick Lorenz OR - Ken
  Rosenberg RI - Sam Viner-Brown SC - Kristen
  Helms
• TX - Kamila Bajwa-Mistry UT - Lois Bloebaum VT
  - Peggy Brozicevic
• WA - Linda Lohdefinck WV - Melissa Baker CDC
  PRAMS Team, Program Services and Development
  Branch, Division of Reproductive Health

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What is PRAMS?

• Ongoing, population-based, state-based
  surveillance of women delivering live infants
• Self-reported data on maternal behaviors and
  experiences before, during, and after pregnancy

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PRAMS Methodology

• Stratified sample drawn from birth certificate
  records 2-6 months after delivery
• Standardized data collection protocol
• Mixed-mode data collection (mail and telephone)

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States Participating in PRAMS, 2001
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CDC and PRAMS Data

• PRAMS Surveillance Reports
• 1995, 1996, 1997, 1998
• Over 20 indicators reported in each
• Current year prevalence data by state and
  sociodemographic characteristics
• Trend data reported by state

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CDC and PRAMS Data

• PRAMS MMWR Surveillance Summary
• 1997, 1999 (in progress)
• 6-7 indicators reported in each
• Current year prevalence data by state and
  sociodemographic characteristics
• Trend data reported by state

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States With 1999 Data
WA
ME
NY
OH
IL
UT
WV
CO
NC
OK
NM
AR
SC
AL
LA
AK
FL
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Data Analysis

• 1999 prevalence estimates by state
• Trend data from 1993-1999 for those states with
  at least three years of data

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Unintended Pregnancy Among Women Delivering a
Live Infant

• Mistimed or unwanted at the time of conception
• Mistimed wanted pregnancy later
• Unwanted did not want pregnancy then or at any
  time in the future

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Unintended Pregnancy Among Women Delivering a
Live Infant, PRAMS 1999
Range 33.7 - 52.0
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Unintended Pregnancy Among Women Delivering a
Live Infant, PRAMS 1993-1999

• No statistically significant change over time

• Statistically significant decrease over time NC

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Smoking During Last 3Months of Pregnancy

• Any cigarette smoking during the last 3 months of
  pregnancy

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Smoking During Last 3 Monthsof Pregnancy, PRAMS
1999
Range 6.2 - 27.2
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Smoking During Last 3 Monthsof Pregnancy, PRAMS
1993-1999

• No statistically significant change over time

• Statistically significant decrease over time
  AK, FL, NY, OK, WA

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Physical Abuse During Pregnancy

• Pushing, hitting, slapping, kicking, or any other
  way of physically hurting
• By husband or partner
• At any time during pregnancy

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Physical Abuse During Pregnancy,PRAMS 1999
Range 2.1 - 6.3
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Physical Abuse During Pregnancy,PRAMS 1996-1999

• No statistically significant change over time

• Not statistically significant, but decreases are
  observed AL, AK, OK

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Breastfeeding Initiation

• Any breastfeeding after delivery

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Breastfeeding Initiation, PRAMS 1999
Range 48.0 - 89.0
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Breastfeeding Initiation,PRAMS 1993-1999

• No statistically significant change over time

• Statistically significant increase AL, AK, AR,
  FL, ME, NY, OK, SC, WA, WV

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Back Sleep Position

• Placing the infant down to sleep on its back most
  of the time

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Back Sleep Position, PRAMS 1999
Range 35.1 - 74.6
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Back Sleep Position, PRAMS 1996-1999

• Statistically significant increase over time
  ALL 12 STATES

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Summary

• Prevalence varies by state
• Little or no progress
• Unintended pregnancy
• Physical abuse by husband or partner during
  pregnancy

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Summary

• Mixed results
• Smoking during last 3 months of pregnancy
• Positive trends
• Breastfeeding initiation
• Back sleep position

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Conclusions

• Value of state-based data
• Progress toward Healthy People objectives and
  Title V performance measures
• Program planning
• Policy decisions