The Hawaii State Department of Health’s (DOH) Family Health Services Division has released its recently completed Pregnancy Risk Assessment Monitoring System (PRAMS) Trend Report. A surveillance project of the U.S. Centers for Disease Control and Prevention, the PRAMS collects state-specific, population-based data on maternal attitudes and experiences before, during and after pregnancy. This trend report highlights changes statewide in 16 indicators since 2000 and provides estimates by county, race, and age groups.

More than 18,000 babies are born in Hawaii each year. With the emphasis on containing health care cost, it is critical to learn about the course of pregnancies, birth outcomes, and trends over time. The PRAMS report identifies groups at greatest risk for poor behavioral practices and/or birth outcomes.

“These are very complex issues which increase the burden of disease and the cost to society,” said Dr. Chiyome Fukino, Director of Health. “Strategies must be developed to improve the physical and emotional health of pregnant women. Identifying and analyzing areas of greatest need is the first step.”

Hawaii’s infant mortality rate is 6.3 per 1,000 live births; low birth weight rate is 7.5 percent; and the prematurity rate is 9.4 percent. Although well within national averages, these rates have not improved over the past 10 years and in some cases there has been a slight downward trend over time. Data from this report identifies important areas of concern that are contributing factors to infant mortality, birth weight and prematurity. These factors must be addressed in order to help improve the health of the pregnant woman and her newborn in Hawaii.

• 45 percent of all births were unintended; the rate is highest for women under twenty years of age with 73 percent.
• 18 percent of pregnant women did not receive prenatal care until after the first trimester; this is especially true if the woman is Samoan, Hawaiian or of other Pacific Islanders descent.
• 16 percent of pregnant women are obese prior to conception; the rate is highest with 50 percent of Samoan women.
• 19 percent of women binge drink in the three months before their pregnancy; the rate is highest for women 20-24 years of age at 26 percent.
• 8.5 percent of women smoke during pregnancy; the Hawai‘i County rate is highest at 12 percent.
• 6.5 percent of pregnant women report experiencing intimate partner violence; the rate is highest for women under 20 years of age at 14 percent.
• 15 percent of women experience post partum depression; the rate is highest for women under 20 years of age at 22 percent.

The PRAMS report highlights the need for further analysis between poverty and the socio-economic determinants of health and the need to collaborate with community partners to develop culturally appropriate services. A copy of the report is available on line at

From the Hawaii State Department of Health.