Project Summary/Abstract – Component A (Core Surveillance) The Colorado Department of Public Health and Environment, in collaboration with the Centers for Disease Control and Prevention, collects data annually on women who have recently given birth through the Colorado Pregnancy Risk Assessment Monitoring System (PRAMS). Data collected in PRAMS include maternal characteristics and behaviors, pregnancy risk factors, and birth outcomes. These data are generalizable to all live births in Colorado because they are based on a probability sample and statistically weighted. PRAMS is an ongoing, population-based surveillance system designed to supplement birth certificate data and to generate state-specific perinatal health data. Each month, a stratified random sample comprised of approximately 2.5 percent of Colorado women who recently had a baby are selected from eligible birth certificates. The sample is stratified by region of residence (Denver Metro, Other Metro, Rural) to ensure an adequate sample in the rural areas of the state. Selected women are asked to complete the PRAMS questionnaire by mail or over the telephone. The questionnaire addresses a variety of health and psychosocial issues such as prenatal and postpartum care, maternal use of alcohol, cigarettes and marijuana, breastfeeding, stress, mental health, infant health, and more. Respondents who complete the questionnaire receive a $20 gift card for participating and are protected under a human subjects research designation. PRAMS has gained importance and visibility over the years because it is a key source for Colorado-specific, population-based data on the prevalence of many health indicators such as unintended pregnancy, receipt of prenatal and postpartum care, breastfeeding initiation and duration, contraceptive use, perinatal substance use, and infant health among women delivering a live birth. These data can be used to identify groups of women and infants at high risk for health problems, to monitor changes in the health status of pregnant and postpartum women, and to measure progress towards goals in improving the health of mothers and infants. PRAMS data are used by state and local Maternal and Child Health programs to plan and evaluate programs and policies aimed at improving the health of mothers and infants.