摘要：Data System. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state-based surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy. PRAMS is conducted by the Centers for Disease Control and Prevention’s Division of Reproductive Health in collaboration with state health departments. Data Collection/Processing. Birth certificate records are used in each participating jurisdiction to select a sample representative of all women who delivered a live-born infant. PRAMS is a mixed-mode mail and telephone survey. Annual state sample sizes range from approximately 1000 to 3000 women. States stratify their sample by characteristics of public health interest such as maternal age, race/ethnicity, geographic area of residence, and infant birth weight. Data Analysis/Dissemination. States meeting established response rate thresholds are included in multistate analytic data sets available to researchers through a proposal submission process. In addition, estimates from selected indicators are available online. Public Health Implications. PRAMS provides state-based data for key maternal and child health indicators that can be tracked over time. Stratification by maternal characteristics allows for examinations of disparities over a wide range of health indicators. The Pregnancy Risk Assessment Monitoring System (PRAMS) is part of the Centers for Disease Control and Prevention (CDC) initiative to reduce infant mortality and low birth weight and promote safe motherhood. PRAMS was implemented in 1987 because infant mortality rates were no longer declining as rapidly as they had been in prior years. 1 Although the US infant mortality rate has dropped 15% over the past decade, the United States continues to have one of the highest infant mortality rates among developed countries, at 5.8 per 1000 live births in 2015. 2 Despite recent declines, preterm birth rates remain high (9.9% in 2016), 3 and sudden infant death syndrome is the leading cause of death among infants 1 to 12 months old (approximately 1600 deaths in 2015). 4 Maternal mortality and morbidity rates have also been increasing. The number of reported pregnancy-related deaths in the United States rose from 7.2 per 100 000 live births in 1987 to 17.3 per 100 000 live births in 2013. 5,6 Moreover, the number of women presenting at delivery with 1 or more chronic conditions rose from 66.9 per 1000 delivery hospitalizations in 2005–2006 to 91.8 per 1000 delivery hospitalizations in 2013–2014. 7
