‘Crisis Level’: US Preterm Birth Rates in 2022 Second Highest Since 2012, Report Says

Increased access to contraception and higher female employment have resulted in ‘more chronic conditions during pregnancy,’ said the March of Dimes.

Children and care givers in a park outside the International Monetary Fund headquarters in Washington on April 12, 2023. Andrew Caballero-Reynolds/AFP via Getty Images

The 2022 preterm birth rate in the United States was the second highest in a decade—a “crisis level” state of infant and maternal care, according to the March of Dimes.

“In 2022, over 380,000 babies were born preterm—10.4 percent of all births—earning the U.S. a D+ for the second year in a row,” said the Nov. 16 report by the infant and maternal care nonprofit.

This represents a tiny dip from 10.5 percent in the previous year. Despite the slight decline, the preterm rate in 2022 was the second highest since 2012. The worst grades were given in the southern region.

Black Americans had the highest preterm rate of 14.6, with Hispanics at 10.1, whites at 9.4, and Asians with the lowest at 9.

The report notes that chronic conditions during pregnancy have risen in recent years due to higher contraception use and more women in employment.

“Increased access to contraception has resulted in lower birth rates among teens and a reduction in unplanned pregnancies. Increases in educational attainment and employment opportunities for women coupled with economic uncertainty and lack of affordable childcare options have all contributed to women having babies later in life,” the report said.

“With these shifts, we see more chronic conditions during pregnancy, putting moms and babies at greater risk for complications. Simultaneously, we’re experiencing a shortage of maternity care providers and declining access to care, creating pockets of communities vulnerable to poor outcomes.”

The following reasons contribute to the likelihood of preterm birth among pregnant women—smoking, hypertension, unhealthy weight, diabetes, previous preterm, and carrying multiple babies.

Over 37 percent of women were found to have one or more preexisting health conditions prior to pregnancy that contribute to the risk of preterm birth.

The United States had an infant mortality rate of 5.4 per 1,000 live births in 2021 with leading causes of death being birth defects, followed by preterm birth and low birth weight, sudden unexpected infant death, accidents, and maternal complications, per the report.

The maternal mortality rate was 32.9 deaths per 100,000 live births in 2021, nearly doubling from 17.4 in 2018.

State Performance

Louisiana, Arkansas, Alabama, Georgia, South Carolina, Mississippi, Kentucky, and West Virginia were the states with the highest preterm births at 11.5 percent and higher, and given the lowest “F” rating. Puerto Rico also was in that category.

Only one state received a “B+” rating indicating a moderate preterm birth rate between 8.2 and 8.5 percent—New Hampshire. No state scored the highest possible “A” rating with a preterm birth rate of 7.7 percent and lower.

“Since last year’s report, 14 states have seen an increase in preterm birth, potentially due to factors such as inadequate prenatal care, greater rates of hypertension, and higher proportions of birthing women at an unhealthy weight,” the report said.

“Conversely, 32 states have improved, and while many factors may influence preterm birth in each population there is no one root cause for this drop. One explanation for the overall improvement could be the difference in COVID-19 variants during the time frame the data was collected.”

Babies born too early, especially before 32 weeks of pregnancy, “have higher rates of death and disability.” Mario Tama/Getty Images

One-third of the 100 American cities with the highest number of live births had a preterm birth grade of “F.”

“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 Dr. Elizabeth Cherot, March of Dimes president and CEO, according to a Nov. 16 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,” she said.

“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.”

Preterm Birth Risks

According to the U.S. Centers for Disease Control and Prevention (CDC), babies born too early, especially before 32 weeks of pregnancy, “have higher rates of death and disability.”

In 2021, preterm birth and low birth weight were responsible for 14.8 percent of infant deaths or deaths before one year of age.

Babies who survive may suffer conditions like cerebral palsy, feeding difficulties, breathing problems, hearing issues, developmental delays, and problems with vision.

Signs of potential early labor include changes in vaginal discharge where there is a significant increase in the amount of discharge, contractions in the abdomen every 10 minutes or more, pelvic pressure, cramps that feel like a menstrual period, and low, dull backache.

The CDC pointed out that important development in infants happens throughout pregnancy, including the final few weeks. As such, “unless there is a medical need, delivery should not be scheduled before 39 weeks of pregnancy.”

In case a pregnant woman thinks she is experiencing preterm labor, she should seek help from a healthcare provider “right away.” The healthcare professional “may be able to give you medicine so that the baby will be healthier at birth,” the agency states.

The March of Dimes report recommended the following steps to improve maternal and infant healthcare:

• Extending Medicaid benefits to one year after the birth of a child, which is currently followed in 37 states and D.C.
• Expanding Medicaid to offer “greater access to preventative care” for pregnant women, currently adopted in 39 states and D.C.
• Offering paid parental leave.
• Establishing maternal and infant mortality review committees to identify the causes and factors of the deaths.

The health advocacy’s findings come after the CDC said in a report earlier this month that America’s infant mortality rate had risen for the first time in over two decades.

In an interview with AP, Danielle Ely, the CDC report’s lead author, said that researchers could not conclude whether the jump in infant mortality rate last year was a one-year blip or the beginning of a trend.

“It would appear that some of the states could be having a larger impact on the (national) rate,” she said while adding that it is hard to determine the exact factors driving the rise in infant mortality.

Marie Thoma, a University of Maryland researcher who studies maternal and infant mortality, told the outlet that the data is “definitely concerning, given that it’s going in the opposite direction from what it has been.”