Hawaii Pregnancy Risk Assessment Monitoring System (PRAMS)

The Hawaii Pregnancy Risk Assessment Monitoring System (PRAMS) Program is a population-based surveillance system designed to identify and monitor maternal experiences, attitudes, and behaviors from preconception, through pregnancy and into the interconception period.  The program is funded by the Centers for Disease Control and Prevention (CDC), Division of Reproductive Health.


PRAMS was developed in 1987 to supplement the birth certificate records by providing  state-specific data on maternal behaviors and experiences to be used for planning and assessing maternal and child health programs. Hawaii PRAMS started out as a pilot program in 1999, with Hawaii becoming an official PRAMS state in 2000. Forty states and New York City currently participate in the PRAMS program (six others participated previously).  This represents approximately 78%  of all U.S. live births. PRAMS provides ongoing monitoring of maternal behaviors to determine how to reduce infant deaths, decrease low birth weights and improve the overall health of the population in Hawaii.


The overall goal of PRAMS is to reduce infant morbidity and mortality by impacting  maternal and child health programs, policies and maternal behaviors during pregnancy and early infancy.

There are four PRAMS objectives:

  1. Collect high quality population-based data on maternal behaviors before and during  pregnancy and during the early life of the infant.
  2. Conduct epidemiologic analysis and study of maternal behaviors and experiences  during pregnancy and early infancy and determine their relationship to health outcomes.
  3. Translate data analyses into useable information for program planning, monitoring and evaluation.
  4. Increase public awareness of healthy pregnancy behaviors to improve maternal health across the life span.



A PRAMS questionnaire is mailed to approximately 200 new mothers per month on all of  the islands of Hawaii. The new moms are randomly selected from the birth certificates of recently  born infants. The questionnaire includes questions that are asked by PRAMS programs in  all states (core) as well as Hawai‘i-specific questions. All questions were developed  and researched by CDC to identify relevant topics and issues. The PRAMS questionnaire  addresses priority maternal and child health issues such as unintended pregnancy, breastfeeding,  smoking and alcohol use, insurance coverage, contraception use,  post-partum depression and intimate partner violence. Hawaii-specific questions are selected by  the PRAMS Program, in partnership with the Hawaii PRAMS Steering Committee, other  Department of Health program staff, and local community stakeholders.



Data collected by the Hawaii PRAMS program is used to enhance discussion about  important health issues facing families in Hawaii. Reports are shared in various  formats including state reports, factsheets, presentations, and published manuscripts.  We hope that these and other products produced using Hawaii PRAMS data will be useful  information to improve the health of everyone in Hawaii.

Hawaii PRAMS 2009-2015 Trend Report:  In 2019, the Hawaii PRAMS 2009-2015 Trend Report was released to describe data for 23 selected indicators of maternal and infant risk factors and outcomes that were selected based on feedback from the Hawaii PRAMS steering committee.  For 10 of the 23 indicators, this report is a continuation of the Hawaii PRAMS Trend Report 2000-2008 as these indicators did not change over time.  A copy of the report is available online at https://health.hawaii.gov/fhsd/files/2019/07/PRAMS-Trend-Report-ALL-FINAL6-2019-LR.pdf

Hawaii PRAMS 2000-2008 Trend Report: In 2010, the Hawaii PRAMS 2000-2008 Trend Report was released to highlight  changes statewide in 16 indicators since Hawaii began collecting data. A copy  of the report is available on line at http://health.hawaii.gov/mchb/files/2013/05/pramstrendreport2010.pdf

County-specific trend reports are available online at the following links:

Kauai County:    http://health.hawaii.gov/mchb/files/2013/05/Kauai_County_PramsReport2011

Prevalence and Risk Factors for Self-Reported Postpartum Depression Symptoms (SRPDS) in Hawai‘i, 2012-2015: Postpartum depression (PPD) affects an estimated 10% to 20% of women in the United States, but little is known about the risk factors for PPD in Hawai‘i. This study sought to identify PPD risk factors and examine whether disparities exist in Hawai‘i. Aggregated 2012-2015 Hawai‘i Pregnancy Risk Assessment Monitoring System (PRAMS) data from 5572 women with a recent live birth were analyzed. Read the full report here

Factsheets: Factsheets are used to increase discussion, focus further analyses, and present  data that may be useful for program planning. The  length of a factsheet is limited and is not meant to portray a complete picture for any one  particular issue.

Archived Factsheets



If you have recently had a baby in Hawaii and received a PRAMS questionnaire to complete,  please do so. Answering the PRAMS questions helps doctors, health professionals, clinics, and  organizations improve health care services for all women and children in Hawaii. A token of  appreciation will be sent to you approximately 4 weeks after we receive your survey. All  questionnaires are kept confidential as provided by Hawaii State law. No reports or responses  will be traced back to mother’s participating in the survey. The Hawaii PRAMS birth sample is  chosen from all women who recently had a live birth. PRAMS provide data not available from other  sources about pregnancy and the first few months after birth. The gathered information can also be  compared to other states participating in PRAMS which can then help maternal and child health  organizations across the country improve their programs and policies. So, the information you  provide on the survey CAN make a real difference!

HAWAII PRAMS FAQ HANDOUTS If you have questions about the Hawaii PRAMS program or Hawaii PRAMS data, feel free to contact the  Hawaii PRAMS Program Coordinator (contact info below).  However, the Hawaii PRAMS program has also developed two handouts with answers to the most common questions received.


Selected Hawaii PRAMS data and reports are available online at the  Hawaii Health Matters, Hawaii Health Data Warehouse (2000-2013 Hawaii PRAMS data only) and Hawaii Indicator Based Information System (2014-current Hawaii PRAMS data) websites.

For further information about the CDC PRAMS Program, please visit the  CDC PRAMS website.

For more information about the Hawaii PRAMS Program, please contact:
Hawaii PRAMS Program Coordinator
Telephone:  808-733-4052
Email: [email protected]