The U.S. earned improved marks in curbing premature birth rates, according to the March of Dimes' most recent annual report card. This year, the nonprofit gave the country a "C" -- up from a "D" in 2010.
Preterm birth rates fell from an all-time high of 12.8 percent in 2006 to 12.2 percent in 2009, according to the new statistics. That is still well short of the organization's 2020 goal of 9.6 percent, as well as the federal government's Healthy People 2020 goal of 11.4 percent.
"March of Dimes is definitely encouraged by the improvement in the rate of preterm birth, but there's a long road ahead," said Dr. Jennifer L. Howse, president of the organization. Preterm refers to any birth that occurs before 37 weeks, and is a key risk factor for newborn death in the U.S., according to the CDC.
Because premature babies have less time to develop in the womb, those who survive also face serious potential health issues, including intellectual disabilities, breathing and respiratory problems and cerebral palsy. The earlier a baby is born, the greater the risks.
While tremendous strides have been made in caring for premature babies, all of the risk factors for early birth are not yet understood. Howse said it is critically important to research the causes -- about half of which she said are still unknown -- to better help prevention efforts.
In the meantime, Howse highlighted several risk factors that can be controlled by women. Number one is lack of health insurance, she said, which impacts women's ability to get to prenatal care early and safely. According to the 2011 report card, the rate of uninsured women of childbearing age increased slightly from last year -- up to 20.8 percent.
Maternal smoking is also a key factor in preterm births, Howse said, explaining that just under 18 percent of women of childbearing age smoke. That is down from 19.6 percent in the 2010 report card rates.
Another factor is early elective cesarean section and induction.
"It's very important for elective induction and C-sections not to be scheduled before 39 weeks," Howse said. "It's happening because consumer education and clinical practice have not yet caught up with nationally established guidelines." March of Dimes has launched an initiative to work on the issue; according to the 2010 report card, the most recent rates of late preterm births also dropped slightly, from 8.8 to 8.7 percent.
The new report card also provides information on the states that ranked the best and the worst regarding preterm birth risk. Puerto Rico, Louisiana, Mississippi and Alabama all received an "F"; Vermont was the only state to receive an "A." It had a preterm birth rate of 9.3 percent.