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Premature Birth: What the Data Reveals

By Dylen Foster

Premature birth affects every 1 in 10 babies in the United States and globally.1 However, the risks and survival odds are not the same everywhere. This article examines the variation in access to prenatal care and healthcare policies across countries and states, as well as the impact of racial and socioeconomic factors on infant and maternal survival outcomes.

What is Premature Birth?

The World Health Organization defines prematurity as “babies born alive before 37 weeks of pregnancy are completed.”1 This is further divided into subcategories based on gestational age, or the duration of a pregnancy: extremely preterm babies (less than 28 weeks), very preterm babies (28 to less than 32 weeks), and moderate to late preterm babies (born 32 to 37 weeks).1

In the United States, there were 373,902 preterm births nationally in 2023, accounting for 10.4% of live births.2 Twenty-two states reported having higher rates than the national percentage, while nineteen states had “met the Healthy People 2030 preterm rate” goal of reducing preterm birth to 9.4%.2 According to the CDC’s National Center for Health Statistics, the percentage of infants in the United States admitted to the NICU has also increased, rising from 8.7% of U.S. infants in 2016 to 9.8% in 2023, highlighting the growing number of babies requiring specialized care.3 Preterm birth is the second leading cause of death for infants after birth defects.2 Preterm birth can lead to “developmental delays, chronic respiratory problems and vision and hearing impairment”, impacting families financially and emotionally.2

Causes and Risk Factors

According to the March of Dimes, preterm birth can “be triggered by multiple, interacting biologic and environmental factors,” and a history of “preterm birth, multiple gestations, and certain uterine and/or cervical problems” increases the risk of premature birth.2

State-by-State Disparities

The March of Dimes, the leading organization advocating for the improvement of infant and maternal health, gave the United States an overall “D+” grade on its 2025 report card.4 The report card grading scale takes into account state data on preterm birth, infant mortality, causes of infant death, and maternal health. The scale also considers factors such as maternal race and insurance type to “underscore how systemic inequities continue to shape health outcomes.”4 Finally, the report card “examines supportive policies and programs that are essential for advancing equity in maternal and infant health.”4

High-Risk States

High-risk states have a grade of a “D” or “F” and include:

  • Mississippi Grade: F Birth Rate: 15.0%4
  • Louisiana Grade: F Birth Rate: 14.0%4
  • West Virginia Grade: F Birth Rate: 13.4%4

Louisiana and Mississippi also have high rates of infant mortality: 7.1 deaths and 8.9 deaths per 1,000 births, respectively.4

Low-Risk States

Low-risk states have a grade of “A” or “B” and include

  • New Hampshire Grade: A- Birth Rate: 7.9%4
  • Vermont Grade: B+ Birth Rate: 8.2%4
  • Oregon Grade: B Birth Rate: 8.9%4

New Hampshire and Vermont also have low rates of infant mortality: 2.9 deaths and 3.2 deaths per 1,000 births, respectively.4

Global Overview

Internationally, preterm birth “is the leading cause of death in children under the age of 5 years.”1 In low-income areas, babies die due to a lack of “cost-effective care such as warmth, breastfeeding support and basic care for infections and breathing difficulties.”1 In contrast, in higher-income countries, those babies are more likely to survive.1 Countries such as India, Pakistan, Ethiopia, Nigeria, and China make up 45% of preterm births.6 Also at risk are countries affected by humanitarian crises such as Afghanistan, Yemen, Somalia, Sudan, the Central African Republic, and the Democratic Republic of Congo.6 The crises in these areas make “access to preventative and curative care for preterm babies … extremely challenging.”6 These global disparities highlight the urgent need for accessible neonatal care and effective interventions worldwide.

Programs That Make a Difference

March of Dimes

A nonprofit organization in the United States focused on improving the health of mothers and babies. The organization focuses on preventing birth defects, premature birth, and infant mortality through research, education, and community programs.9

The PREEMIE Act

The PREEMIE Act, first passed in 2006, aims to reduce preterm births and their consequences.7 While the PREEMIE Reauthorization Act of 2023 was not reauthorized, the PREEMIE Reauthorization Act of 2025 is a top priority for organizations involved in maternal and infant health. The Reauthorization Act of 2025 was “introduced by Sen. Bennet (D-CO), Sen. Boozman (R-AR) in the Senate on May 1, 2025, and by Rep. Kelly (D-IL), Rep. Miller-Meeks (R-IA), Rep. Fletcher (D-TX), Rep. Carter (R-GA), Rep. Brown (D-OH), and Rep. Kiggans (R-VA)” on February 11, 2025, in the House of Representatives.7

Global Alliance to Prevent Prematurity and Stillbirth

Known as GAPPS, the organization aims to improve maternal, newborn, and child health outcomes by addressing preterm birth and stillbirth by focusing on accelerating research, increasing awareness, and advocating for evidence-based interventions.8

Sources

  1. “Preterm Birth.” World Health Organization, www.who.int/news-room/fact-sheets/detail/preterm-birth. Accessed 05 Dec. 2025.
  2. March of Dimes. “A Profile of Prematurity of United States.” March of Dimes | PeriStats, www.marchofdimes.org/peristats/reports/united-states/prematurity-profile. Accessed 05 Dec. 2025.
  3. “Products – Data Briefs – Number 525 – March 2025.” Centers for Disease Control and Prevention, 19 Mar. 2025, www.cdc.gov/nchs/products/databriefs/db525.htm. Accessed 05 Dec. 2025.
  4. March of Dimes. “2025 March of Dimes Report Card for United States.” March of Dimes | PeriStats, www.marchofdimes.org/peristats/reports/united-states/report-card. Accessed 05 Dec. 2025.
  5. “Preterm Labor and Preterm Birth: Are You at Risk?” March of Dimes, www.marchofdimes.org/find-support/topics/birth/preterm-labor-and-preterm-birth-are-you-risk. Accessed 05 Dec. 2025.
  6. “Why Premature Babies’ Survival Often Depends on Where They Were Born.” Doctors Without Borders – USA, www.doctorswithoutborders.org/latest/why-premature-babies-survival-often-depends-where-they-were-born#:~:text=Where%20is%20prematurity%20most%20common,babies%20can%20be%20extremely%20challenging. Accessed 05 Dec. 2025.
  7. “Preemie Reauthorization Act.” March of Dimes, 14 Nov. 2022, www.marchofdimes.org/our-work/policy-advocacy/federal-advocacy/preemie-act. Accessed 05 Dec. 2025.
  8. Gapps. “Mission Vision & Values.” GAPPS, www.gapps.org/Home/MissionVisionValues. Accessed 05 Dec. 2025.
  9. “Our Mission.” March of Dimes, 27 Sept. 2022, www.marchofdimes.org/about-us/mission. Accessed 05 Dec. 2025.

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