US Earns D+ for Preterm Birth Rate for Third Consecutive Year in 2024 March of Dimes Report Card, Remaining Worst Grade in Report History

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The 2024 Report Card reveals over 370,000 babies were born preterm in 2023, with one-third of the largest US cities receiving an F grade for preterm birth rates. Twenty-four states experienced worsening rates, many in the southeastern US, with Black birthing people facing preterm birth rates 1.4 times higher than their peers.

The report reveals many risk factors for preterm birth are not improving, including inadequate prenatal care and chronic health issues. In 2023, the rate of inadequate prenatal care rose to 15.7%, the highest in a decade, with even higher rates among Black and American Indian/Alaska Native communities. Lack of adequate prenatal care is linked to a 9% increase in the rate of preterm birth compared to those who receive adequate prenatal care, stressing the need for early intervention. Chronic conditions like hypertension and diabetes remain significant risks, with pre-pregnancy hypertension rising over 10% in just one year. This condition, a leading cause of preeclampsia, can dangerously elevate blood pressure and lead to preterm birth.

"As a clinician, I know the profound impact that comprehensive prenatal care has on pregnancy outcomes for both mom and baby," said Dr. Amanda P. Williams, Interim Chief Medical Officer at March of Dimes. "Yet, too many families, especially those from our most vulnerable communities, are not receiving the support they need to ensure healthy pregnancies and births. The health of mom and baby are intricately intertwined. If we can address chronic health conditions and help ensure all moms have access to quality prenatal care, we can help every family get the best possible start."

New in this year's report, March of Dimes examined environmental factors impacting maternal and infant health outcomes. Research shows pregnant people exposed to extreme heat and air pollution are more likely to give birth preterm, have underweight or stillborn babies, and suffer from preeclampsia. Nearly 40% of birthing people are at risk of exposure to extreme heat at some point in their pregnancy, while almost three in four birthing people are at risk of exposure to poor air quality.

"Every baby deserves the chance for a healthy start, yet the data continue to show unacceptable health outcomes for far too many families," said Cindy Rahman, March of Dimes Interim President and CEO. "March of Dimes is committed to advocating for policies that make healthcare more accessible like Medicaid expansion, addressing the root causes of disparities, and increasing awareness of impactful solutions like our Low Dose, Big Benefits campaign, which supports families and communities to take proactive steps toward healthy pregnancies."

Key findings from the 2024 Report Card:

Preterm birth: The national preterm birth rate remains at 10.4% with Black moms facing a preterm birth rate of 14.7%, almost 1.5 times higher than the national average.

Inadequate prenatal care: Rates of inadequate prenatal care reached 15.7%, the highest in a decade with disparities most pronounced in Black and AI/AN communities.

Maternal mortality: Rates have returned to pre-pandemic levels with over 800 maternal deaths in 2022, a national rate of 22 deaths per 100,000 live births, with Black and AI/AN moms experiencing rates 2-3 times higher than White moms.

Infant mortality: Preterm birth remains the leading cause of infant mortality, which rose by 3% in 2023—the largest increase in over 20 years. Black infants are nearly twice as likely to die in their first year than the national average.

Environmental exposure: Nearly 40% of birthing individuals are at risk of exposure to extreme heat, while almost three in four birthing people are at risk of exposure to poor air quality.

This latest report comes on the heels of "Nowhere to Go: Maternity Care Deserts Across the US," which revealed the worsening state of maternity care access in the US. The latest data shows that more than 6 million women live in counties with no or limited access to maternity care services, a situation exacerbated by recent hospital closures and reductions in obstetric services. March of Dimes calls on state and federal legislators to expand and extend Medicaid coverage, increase access to quality prenatal care, and establish environmental safeguards to protect at-risk communities. The organization also champions the expansion of its Mom & Baby Mobile Health Centers^®, which bring essential healthcare services to underserved areas, with new centers planned in Houston, Cleveland, Birmingham, and Arizona.

To learn more:

• More details on the 2024 Report Card and March of Dimes initiatives are available at marchofdimes.org/reportcard.
• Additional information on our Report Card and maternity care desert reports can be found on PeriStats™, the online source for perinatal statistics developed by the March of Dimes Perinatal Data Center. PeriStats provides free access to maternal and infant health-related data at the US, state, county, and city level. Over 60,000 graphs, maps and tables are available on PeriStats, and data are always referenced to the relevant source and Healthy People 2030 objective.

About March of Dimes
March of Dimes leads the fight for the health of all moms and babies. We support research, lead programs, and provide education and advocacy so that every family can have the best possible start. Since 1938, we've built a successful legacy to support every pregnant person and every family. Visit marchofdimes.org or nacersano.org for more information. Follow us on social at @marchofdimes.

SOURCE March of Dimes Inc.