Surveillance for Disparities in Maternal Health-Related Behaviors — Selected States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2001

• Published in: MMWR. Surveillance summaries 2004-07, Vol.53 (SS-4), p.1-13
• Main Authors: Phares, Tanya M., Morrow, Brian, Lansky, Amy, Barfield, Wanda D., Prince, Cheryl B., Marchi, Kristen S., Braveman, Paula A., Williams, Letitia M., Kinniburgh, Brooke
• Format: Article
• Language: English
• Subjects: African Americans; Alcohols; Breastfeeding; Female; Health Behavior - ethnology; Healthy People Programs; Hispanics; Humans; Income level; Infant; Infant Care - statistics & numerical data; Infant, Newborn; Infants; Maternal Behavior - ethnology; Population Surveillance; Postnatal Care - statistics & numerical data; Pregnancy; Prenatal Care - statistics & numerical data; Risk analysis; Risk Assessment; Socioeconomic Factors; Surveillance; Womens education
• ISSN: 1546-0738; 1545-8636

Problem/Condition: Disparities in maternal and infant health have been observed among members of different racial and ethnic populations and persons of differing socioeconomic status. For the Healthy People 2010 objectives for maternal and child health to be achieved (US Department of Health and Human Services. Healthy People 2010. 2nd ed. With understanding and improving health and objectives for improving health [2 vols.]. Washington DC: US Department of Health and Human Services, 2000), the nature and extent of disparities in maternal behaviors that affect maternal or infant health should be understood. Identifying these disparities can assist public health authorities in developing policies and programs targeting persons at greatest risk for adverse health outcomes. Reporting Period Covered: 2000-2001. Description of System: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state-and population-based surveillance system designed to monitor selected maternal behaviors and experiences that occur before, during, and after pregnancy among women who deliver live-born infants. PRAMS employs a mixed mode data-collection methodology; up to three self-administered surveys are mailed to a sample of mothers, and nonresponders are followed up with telephone interviews. Self-reported survey data are linked to selected birth certificate data and weighted for sample design, nonresponse, and noncoverage to create annual PRAMS analysis data sets that can be used to produce statewide estimates of different perinatal health behaviors and experiences among women delivering live infants in 31 states and New York City. This report summarizes data for 2000-2001 from eight states (Alabama, Colorado, Florida, Hawaii, Illinois, Maine, Nebraska, and North Carolina) on four behaviors (smoking during pregnancy, alcohol use during pregnancy, breastfeeding initiation, and use of the infant back sleep position) for which substantial health disparities have been identified previously. Results: Although the prevalence of each behavior varied by state, consistent patterns were observed among the eight states by age, race, ethnicity, education, and income level. Overall, the prevalence of smoking during pregnancy ranged from 9.0% to 17.4%. Younger (aged < 25 years) women, white women, American Indian women, non-Hispanic women (except in Hawaii), women with a high school education or less, and women with low incomes consistently reported the highest rates of smoking. O