After five years of increases, the U.S. preterm birth rate dipped slightly from 10.2% in 2019 to 10.1% in 2020, according to the 2021 March of Dimes Report Card.
Black and American Indian/Alaska Native women are up to 60% more likely to give birth preterm compared to Whites. Prematurity rates increased from 14.25% to 14.36% for Black women and from 11.55% to 11.61% for Native women.
There were 364,487 preterm births in 2020 — down from 383,061 — and the nation retained its “C-” grade. In addition, more than 700 women die from pregnancy-related causes annually.
The report card grades the U.S. and states plus the District of Columbia and Puerto Rico, along with 100 cities. It also addresses infant death, social vulnerability (social determinants of health by county) and other maternal and child health issues.
Vermont was the only state to receive an “A.” Its prematurity rate of 7.6% was below the criteria of 7.7% or lower. Six Southern states received an “F,” reflecting rates of 11.5% or higher.
While preterm birth rates declined in 33 states, Washington, D.C., and Puerto Rico, 13 states saw increases and four remained the same.
The latest infant mortality data also showed a slight decline, from 5.7 deaths per 1,000 live births in 2018 to 5.6 deaths per 1,000 in 2019. For Blacks, the infant mortality rate was 10.9 per 1,000 in 2018.
The babies of Black and Native women are twice as likely as White babies to die before their first birthday.
Overall, infant mortality rates improved in 18 states, worsened in 11 states and stayed the same in 21 states.
Longstanding inequities in communities of color, magnified during the pandemic, contribute to the poor outcomes, Stacey D. Stewart, president and CEO of March of Dimes, noted during a panel discussion on Monday.
She said no single cause explains the disparities that underlie infant prematurity and mortality rates.
“I think part of the answer is that we are dealing with a lot of historic challenges that have plagued this country for hundreds of years,” said Stewart, adding that the U.S. remains at a crisis level with respect to these disparities.
The panel said policy changes are required at all levels. The March of Dimes report includes recommendations to improve health outcomes, including extending Medicaid coverage for postpartum mothers for 12 months, as a third of all maternal deaths happen a week to a year after the baby is born..