Document Type


Publication Date



The health status of South Dakotans is commonly reported from public health surveillance surveys. Surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) provide information that is used by policy makers, public health professionals, advocacy groups, health care organizations, and others to develop initiatives to improve the health of the population. South Dakota has one of the highest infant mortality rates in the U.S., ranking in the bottom half of states, yet there are little data available on factors that influence health behaviors and attitudes of mothers that can ultimately influence birth outcomes. The Pregnancy Risk Assessment Monitoring System (PRAMS) survey is a Centers for Disease Control and Prevention (CDC) recommended tool to provide this type of information. The CDC established the PRAMS in 1987 to obtain information about maternal behavior and experiences that may be associated with adverse birth outcomes. The survey is disseminated to women who have recently given birth to live-born infants. In 2014, 40 states participated in PRAMS and provided data to the CDC. South Dakota has not been funded by CDC and has not conducted a statewide PRAMS. In 2007, however, a Tribal PRAMS was conducted that included all South Dakota American Indian births over a 6-month period. In 2013 the South Dakota Department of Health contracted with the Ethel Austin Martin Program at South Dakota State University to conduct a statewide PRAMS-like survey during 2014. It was decided that the 2014 South Dakota PRAMS would follow the CDC PRAMS protocol. A random sample of South Dakota residents who delivered a live-born infant in 2014 was selected from birth certificate files to complete the survey through mail, online website or by telephone. American Indian and other race infants were oversampled to ensure sufficient numbers to obtain reliable estimates. Data were collected on a variety of topics that included: intendedness of pregnancy, access to prenatal care, health insurance, infant sleeping positions, medical problems during pregnancy, delivery of the infant, and health-related behaviors of the mother (e.g., smoking and alcohol use). The majority of the questions came from the CDC PRAMS core and standardized questions. In addition, questions about adverse childhood experiences (ACE) were added due to the increasing recognition of the role of stress in early life on adult behaviors and health. Questions about illegal drug use during the three months prior to pregnancy also were added in August of 2014. The 2014 PRAMS provides information for South Dakota to assess overall pregnancy experiences and maternal health behaviors, and data from the PRAMS may be used to develop, modify, or evaluate programs for new mothers and their children. Furthermore, the PRAMS will provide useful baseline data to assess future trends in problematic areas. The 2014 PRAMS was implemented to collect this information and to demonstrate the statewide capacity to successfully conduct the PRAMS in South Dakota.








South Dakota State University

Included in

Nutrition Commons