U.S. stuck with D+ in preterm-birth report

Axios – Monday, November 17, 2025
By Carly Mallenbaum

The U.S. has earned a D+ for its preterm-birth rate for the fourth straight year in an annual report from March of Dimes, with the national rate stuck at 10.4%.

Why it matters: The report underscores persistent gaps in equity, access and maternal care. It should be a “wake-up call” that change is needed in the U.S., says Michael Warren, the chief medical and health officer of March of Dimes, a nonprofit focused on ending preventable preterm birth and infant death.

Context: Preterm babies — born before 37 weeks of pregnancy — may not be fully developed at birth, leading to more health problems.

By the numbers: Although 19 states improved their preterm-birth percentages, 21 states worsened, per the report that relies on CDC data.

South Dakota saw the biggest rate decrease (10% lower), while D.C. saw the steepest rate increase (8% higher).

New Hampshire received the best grade: an A- for its 7.9% preterm-birth rate. And Mississippi got the lowest: an F for its 15% rate.

The fine print: The grades are calculated based on how far away they are from a goal rate of 8.1%.

Between the lines: There are major infant health discrepancies when it comes to race, Warren tells Axios.

9.5% of babies born to white mothers were preemies.

14.7% of babies born to non-Hispanic Black mothers were preemies.

What we’re hearing: “There’s no biological reason” for the major state and racial differences in preterm-birth rate, Warren says.

Instead, factors like poverty, housing stability and discrimination influence these health outcomes, he says.

Many expectant mothers lack access to maternity-care services and may skip prenatal visits and other appointments. A separate March of Dimes report found that more than a third of U.S. counties lack a single obstetric clinician.

What we’re watching: Whether funding cuts from President Trump’s “big, beautiful bill” lead to more maternity-care deserts across the country.

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