DP21-001 Nebraska Pregnancy Risk Assessment Monitoring System

Project Summary Nebraska Pregnancy Risk Assessment Monitoring System (NE PRAMS) has provided quality and comprehensive data on maternal and child health risks and behaviors since 1999, and has become a major participant in the state’s strengthened public health system. PRAMS complements the vital records database adding nuances that only self-reported data can do. On the surface, Nebraska appears to have very good pregnancy outcomes. However, the large percentage (69.6% in 2017-2018) of White births drives state averages, and masks considerable disparity when outcomes are examined by maternal race and ethnicity. The Lifespan Health Services Unit is home not only to Maternal and Child Health (MCH) Epidemiology and NE PRAMS, but also to the rest of the MCH-related programs. These programs have been among the strongest supporters of PRAMS and users of the data; being housed in the same unit makes PRAMS data and staff easily accessible to those programs. PRAMS data has been integrated into the official MCH priorities. High-quality, Nebraska specific, population-level data are scarce on key factors such as behavioral risks, and mothers’ experiences with and perceptions of health care. Thus, the birth certificate registry is limited in its ability to provide detailed information for program planning and evaluation. NE PRAMS is currently the only readily-accessible source for population-level data on important issues such as pregnancy intendedness, reasons for patterns of prenatal care use, nutritional status of the mother, preconception health, and for postnatal behaviors such as depression, infant sleep position, and breastfeeding. Importantly, PRAMS data allow valid statements to be made about “new Nebraska mothers” rather than only for selected populations or program recipients. NE PRAMS stratifies by race/ethnicity and will continue to provide data to plan strategies to address these issues and for evaluation.