March of Dimes Gives US D+ Premature Birth Grade on 2023 Report Card

Recently, March of Dimes released its annual report card on maternal and infant outcomes across the United States and its territories, highlighting that the US received a D+ for premature birth, with a rate of 10.4% premature births in 2022.

Defining premature birth as delivery before 37 weeks of gestation, no state in the US received an A, which correlated with a preterm birth rate of 7.7% or lower. While the overall grade was a D+, some states fared better than others.

For example, while many southern states, including Alabama, Georgia, South Carolina, and Louisiana, received an F, with rates of 11.5% or greater, other states on the West Coast achieved a B or B–.

The report indicated minimal change in the country’s preterm birth rate since 2012 despite advancing technology and healthcare. Moreover, the organization noted that the preterm birth rate increased from 9.8% to 10.4% in the past decade.

The organization highlighted six factors that can contribute to preterm birth, including smoking status, hypertension, weight complications, diabetes, previous preterm delivery, and carrying multiples.

Multiple births contributed to 62.2% of all premature births despite accounting for only 3.2% of total deliveries. Among the six biological factors mentioned in the report, carrying multiples was the most significant indicator of premature birth.

Following multiple births and previous preterm births, which contributed to 30.0% of all preterm births in 2022, chronic conditions such as hypertension and diabetes were significant indicators of preterm birth risk, accounting for 23.4% and 28.8%, respectively.

Beyond identifying rates based on geographic region, March of Dimes analyzed how preterm birth rates differed across racial groups. The findings indicated racial inequities for Black birthing individuals.

According to the report, Black birthing people are approximately 1.5 times more likely to deliver prematurely than all other birthing individuals, with the highest preterm birth rates. Meanwhile, Asian and White people giving birth were the least likely to deliver prematurely.

The results of this report card underscore the racial inequities and systemic factors that produce worse maternal and infant outcomes in Black patients.

"This year's report shows the state of infant and maternal health in the United States remains at crisis level, with grave disparities that continue to widen the health equity gap," said Elizabeth Cherot, MD, March of Dimes President and CEO, in the press release. "We have long known that many of the factors impacting poor outcomes for moms and babies can and must be addressed if we are to reverse these trends. The fact is, we are not prioritizing the health of moms and babies in this country, and our systems, policies, and environments, as they stand today, continue to put families at great risk."