U.S. Preterm Birth Rates Have Not Improved in a Decade: Report

The March of Dimes indicates that the United States only deserves a grade of D+ in addressing preterm birth rates, which continue to be dangerously high, especially in Southeastern parts of the country, where many women lack maternity care.

Preterm birth occurs when a baby is born before 37 weeks of gestation, which can increase the risk of serious complications, due to low birth weight and organs not being fully developed. This can result in various negative health effects throughout infancy and childhood.

This month, the March of Dimes released its 2024 Report Card, outlining the various factors that contribute to maternal and infant mortality rates throughout the U.S., indicating that insufficient steps are being taken to address preterm birth rates in the U.S., which have not improved in at least a decade.

March of Dimes is a nonprofit organization focusing on preventable maternal and infant health risks, including preterm birth. The organization funds research, education programs and health advocacy.

The group’s annual health report card rates the U.S. and individual states on maternal health and death, infant health and death, and preterm birth. For the third year in a row, the March of Dimes has given the United States a D+ grade, since preterm birth rates remain historically high, and disproportionately impact certain racial and ethnic groups.

Preterm Birth Rates Remain Unchanged

In 2024, about 370,000 infants were born preterm. That adds up to about 10.4% of babies, which is largely unchanged from last year, when 10.5% of infants were born premature. In addition, the number has not improved since 2013, when it was 9.8%, indicating the U.S. has done little to improve preterm birth rates in over a decade.

The group indicates that the risk of preterm birth is much higher among Black women, who have preterm birth rates 1.4 times larger than other groups.

The data indicated that one-third of the largest cities in the country received an F grade, and 24 states had rates worse than prior years, primarily in the Southeastern United States. Alabama, Arkansas, Georgia, Louisiana, Mississippi and South Carolina had the worst rates of any states, and were especially plagued by issues caused by a lack of abortion care, lack of medical centers for maternity care and medical staff shortages.

The March of Dimes report also indicated risk factors that contribute to preterm birth are not improving, including chronic health issues like hypertension and diabetes. Both conditions increased by more than 10% in one year.

Pre-pregnancy hypertension is the leading cause of preeclampsia, a serious condition marked by high blood pressure that can cause preterm birth and lead to death if not treated quickly.

Lack of Prenatal Care

Many women also lacked prenatal care or had inadequate care, according to the report. The latest available numbers indicate the rate of inadequate care increased to 16%, the highest rate in 10 years, which is linked to a 9% increase in preterm births. Black and American Indian/Alaska Native people faced even worse rates.

“[T]oo many families, especially those from our most vulnerable communities, are not receiving the support they need to ensure healthy pregnancies and births,” said Dr. Amanda P. Williams, Interim Chief Medical Officer at March of Dimes.

The report also notes that climate change affects preterm birth rates, as women exposed to extreme heat and air pollution are more likely to give birth prematurely, have stillborn babies, and suffer from preeclampsia.

More than 40% of pregnant women are at risk of exposure to extreme heat during pregnancy, and 75% are exposed to air pollution or poor air quality, the report indicates.

Researchers said there is an urgent need for the United States to prioritize the health of both infants and mothers, to invest in maternal healthcare programs and prenatal care, and to launch prevention education.