Abstract Component A: Core Surveillance Nevada Pregnancy Risk Assessment Monitoring System (PRAMS): RFA-DP-21-001 Abstract Existing data suggest numerous Nevada maternal and infant health outcomes are unfavorable compared to national rates and HRSA Maternal and Child Health Bureau indicators. Nevada falls below the US national average for critical outcomes such as prenatal care and preventive medical visits, and has higher rates of cesarean deliveries, early term births, low birth weight deliveries, postneonatal mortality, and neonatal abstinence syndrome. For many indicators racial disparities exist like those experienced nationally; in particular, Black mothers and infants in Nevada experience disproportionally increased rates of sudden unexpected infant death, postneonatal mortality, and cesarean deliveries. Data sets such as vital records provide limited data to explore the risk factors associated with these outcomes. This award will expand Nevada’s ability to examine these outcomes. Nevada does not have any other comprehensive system available to monitor perinatal trends to guide program activities, health policy, and resource allocation. PRAMS will enable Nevada to implement surveillance activities of high scientific quality on selected maternal attitudes, behaviors, and experiences that occur before, during, and after pregnancy. Nevada PRAMS data will help elucidate the reasons for maternal behaviors, such as choosing not to breastfeed or not seeking prenatal care and will help determine the prevalence of domestic/intimate partner violence, postpartum depression, and contraceptive use. PRAMS data will be used to make data-driven programmatic decisions to tailor activities to improve birth outcomes and systems of care for Nevada mothers and children and enhance the State’s capacity to evaluate the impact of program activities.