Preterm birth statistics: why 1 in 10 U.S. babies still arrive too early

She was 34 weeks and 2 days when her blood pressure climbed and the proteinuria appeared. We had talked about the possibility for weeks (chronic hypertension, a prior early delivery, a cervix that had already been watched) and still the call came at 2 a.m. By morning she was on magnesium, the neonatology team had a bed, and her partner was standing outside the NICU window looking at a baby who weighed just over four pounds. The baby did well. The family spent 18 days there. The bill, before insurance, ran into six figures.

That is the clinical face of a number reporters ask for every November, when March of Dimes releases its annual report card. In 2024, according to the National Center for Health Statistics, 10.41% of live births in the United States were preterm, born before 37 completed weeks of gestation. The rate was unchanged from 2023. Roughly 1 in 10 American babies still arrive too early.

This page is built so a reporter on deadline, a clinician explaining risk, or an AI answer engine can lift one clean figure and credit the primary source sitting next to it. The national rate first. Then the decade that failed to move it, the late-preterm majority, the racial gap, risk factors, NICU use and cost, the March of Dimes grades, and what follows survivors after discharge.

Year	Preterm rate
2014	9.57%
2015	9.63%
2016	9.85%
2017	9.93%
2018	10.02%
2019	10.23%
2020	10.09%
2021	10.49%
2022	10.38%
2023	10.41%
2024	10.41%

Source: NCHS Data Briefs and Vital Statistics Rapid Release reports, National Vital Statistics System natality data, 2014-2024.

The national rate has barely moved

Start with the number the press release will quote. The National Center for Health Statistics put the 2024 preterm birth rate at 10.41% of live births. That is identical to the final 2023 figure. NCHS defines preterm as fewer than 37 completed weeks of gestation on the obstetric estimate, the standard for national trends since 2007.

March of Dimes rounds the same data to 10.4% and counts 377,204 preterm births in 2024 (nearly 380,000 babies, or 1 in 10 births) and notes that the United States remains among the highest-rate high-income countries. The precise NCHS figure is 10.41%.

The decade behind that number is not a success story. NCHS data briefs document a recent low of 9.57% in 2014, then a climb through 10.23% in 2019, a dip to 10.09% in 2020, a 4% jump to 10.49% in 2021, the highest since 2007, then 10.38% in 2022 and 10.41% in 2023 and 2024. NCHS has described the rise from the 2014 low through 2019 as 7%, and the rate has remained above 10% every year since 2018.

Healthy People 2030 objective MICH-07 sets a national target of 9.4%. In 2024, only 11 states met that goal, per March of Dimes. The country as a whole is not on track. For context on how preterm birth sits inside the broader maternal-health crisis, see our reviews of preventable maternal deaths and Black maternal health disparities.

Maternal race / origin	Preterm rate	Early preterm (<34 wks)
Non-Hispanic Black	14.86%	4.84%
American Indian / Alaska Native	12.59%	3.36%
Native Hawaiian / Other Pacific Islander	12.50%	3.39%
Hispanic (any race)	10.07%	2.56%
Non-Hispanic White	9.49%	2.26%
Non-Hispanic Asian	9.16%	2.30%
All races and origins	10.41%	2.72%

Source: Hamilton BE et al., Births: Provisional Data for 2024, NCHS Vital Statistics Rapid Release No. 38, Table 3.

Late preterm vs early preterm

Not all preterm births carry the same risk. NCHS splits the 2024 rate into late preterm (34-36 completed weeks) at 7.69% of all births and early preterm (under 34 weeks) at 2.72%. Late-preterm births are the large majority of the preterm total; early preterm is a smaller share of births but a much larger share of morbidity and mortality, and most of the cost.

The late-preterm piece is also what has been climbing. NCHS notes that late-preterm rates for 2021 (7.67%), 2023 (7.64%), and 2024 (7.69%) are among the highest reported since at least 2007. Early preterm declined slightly from 2.76% in 2023 to 2.72% in 2024. The plateau in the overall rate is not a story of fewer fragile babies; it is a large late-preterm population alongside a stubborn early-preterm group.

Late-preterm infants are not "almost term." They have higher rates of respiratory distress, temperature instability, hypoglycemia and jaundice, along with feeding difficulty than infants born at 39-40 weeks. Many still need intermediate or intensive care. March of Dimes PeriStats estimates that in an average week in 2024, 7,253 babies were born preterm in the United States, of whom 5,357 were late preterm and 1,070 were very preterm (under 32 weeks). The NCHS percentages remain the authoritative national rates.

The race gap that will not close

In 2024, the preterm rate among non-Hispanic Black mothers was 14.86%, up 1% from 14.65% in 2023, according to NCHS. Non-Hispanic White mothers were at 9.49%. That is a 5.37-point absolute gap. American Indian and Alaska Native mothers were at 12.59%, Native Hawaiian and Other Pacific Islander mothers at 12.50%, Hispanic mothers at 10.07%, and Asian mothers at 9.16%.

Early preterm is sharper still. Black mothers had an early-preterm rate of 4.84% in 2024: more than double the 2.26% rate among White mothers. That is where survival risk, cerebral palsy, chronic lung disease, and six-figure NICU stays concentrate. March of Dimes PeriStats, averaging 2022-2024, reports Black infants at 14.7% preterm, about twice the 9.3% rate among Asian/Pacific Islander infants. The national letter grade stays D+ partly because the average will not fall while the highest-risk group remains near 15%.

These patterns track structural conditions more than genetics: limited obstetric capacity, higher chronic hypertension and diabetes, delayed prenatal care, and stress from discrimination and economic insecurity. Our analyses of maternity care deserts and preeclampsia describe several of the same drivers. The data is stronger on the size of the gap than on any single intervention that closes it at scale.

Who is at highest risk

Preterm birth is multifactorial. Prior preterm birth, multiples and cervical or uterine anomalies remain the strongest clinical predictors. In 2024, 62.3% of multiple births were preterm versus 8.8% of singletons, per March of Dimes PeriStats. Multiples were 3.1% of live births. That is a small share of pregnancies and a large share of preterm deliveries. Families using fertility treatment should know that transferring multiple embryos raises this risk; our IVF due-date calculator and infertility and IVF statistics put that tradeoff in context.

Maternal age cuts both ways. During 2022-2024, PeriStats reports the highest rates among women ages 40 and older (14.7%), followed by women under 20 (10.9%), ages 30-39 (10.6%), and ages 20-29 (9.7%). Short interpregnancy interval also matters: 31.5% of pregnancies with a prior live birth had spacing under 18 months (2018-2020 average). Postpartum contraception counseling is prevention work. For patients tracking the return of cycles, our ovulation calculator and period calculator can help interpret irregular menses, though they do not replace clinical advice on safe spacing.

Medical comorbidities (chronic hypertension, preeclampsia, diabetes and obesity-related complications) drive many indicated preterm deliveries. Gestational diabetes alone is common enough to shift population rates; see our gestational diabetes statistics. Smoking remains a classic modifiable risk; PeriStats cites 9.0% of women of childbearing age reporting smoking in 2024. Access is harder to checkbox: late or no prenatal care, uninsurance (about 10.2% of women of childbearing age in 2023), and counties without obstetric services all delay detection of rising blood pressure or growth restriction. The national cesarean rate was 32.4% in 2024, per NCHS. That overlaps with populations with preterm risk, as covered in our cesarean section statistics.

Group / marker	Preterm share	Period
Multiple births	62.3%	2024
Singleton births	8.8%	2024
Maternal age 40+	14.7%	2022-2024 avg
Maternal age under 20	10.9%	2022-2024 avg
Maternal age 20-29	9.7%	2022-2024 avg
Interpregnancy interval <18 months (share of pregnancies with prior live birth)	31.5%	2018-2020 avg

Source: March of Dimes PeriStats, Profile of Prematurity: United States (NCHS natality base data).

NICU admission and cost

NICU use is rising even where preterm rates are flat. NCHS Data Brief No. 525 found that 9.8% of U.S. infants were admitted to a NICU in 2023, up 13% from 8.7% in 2016. Among preterm infants, admission rose from 49.1% to 51.6%. Preterm and low-birthweight infants were at least seven times as likely to be admitted as infants born later and heavier. Full-term NICU admissions also increased (3.5% to 3.8%), which raises questions about changing admission thresholds and coding. The data brief documents the trend without fully settling the causes.

Among newborns with employer-sponsored insurance, the Health Care Cost Institute reported average spending of $71,158 per NICU admission in 2021 (range $4,488 at the 10th percentile to $161,929 at the 90th), with an average length of stay of 14 days. Level IV care for the sickest infants averaged over $128,000 per admission in that commercial sample.

At the population level, Waitzman, Jalali and Grosse updated lifetime societal costs of preterm birth for the 2016 U.S. birth cohort to $25.2 billion, or about $64,815 per preterm birth (2016 dollars). Lifetime medical care accounted for $17.1 billion. Extremely preterm infants (under 28 weeks) averaged $344,355, more than twelve times the $28,367 estimate for moderate preterm (32-36 week) infants, and over one-third of total costs despite being a small fraction of the cohort. March of Dimes still cites the $25.2 billion figure; absolute dollars today would be higher, but it remains the standard peer-reviewed national benchmark.

Preterm-related causes, when grouped, account for 35.7% of infant deaths, according to March of Dimes analysis of linked birth/infant death data. CDC separately notes that preterm birth and low birth weight accounted for about 14.0% of infant deaths in 2022 as a single underlying-cause category. That is a narrower definition. Both numbers measure different slices of the same problem.

The March of Dimes report card

Every November, roughly on World Prematurity Day, March of Dimes releases state grades that drive local news. The grading scale is explicit: A is 7.7% or less; D+ is 10.4% to 10.7%; F is 11.5% or greater. The 2025 Report Card, based on 2024 natality data, assigned the United States a D+ for the fourth consecutive year. That is the longest stretch at that grade in Report Card history.

Half of all U.S. states received a D or an F. More states saw preterm birth worsen than improve compared with 2023: 21 worsened, 19 improved, and 12 were unchanged (including D.C. and Puerto Rico). Only 11 states met the Healthy People 2030 target of 9.4%. One-third of the 100 U.S. cities with the greatest number of live births earned an F.

For reporters, the report card is a news peg and a secondary source. Underlying rates come from NCHS natality files. When you need one national number, prefer "10.41% in 2024, National Center for Health Statistics" or "10.4%, March of Dimes 2025 Report Card, based on NCHS 2024 data." The letter grade is March of Dimes' own framing. State rankings shift annually: pull the current PeriStats report card rather than last year's PDF on deadline.

What happens after discharge

Survival has improved dramatically for preterm infants over three decades. What follows survival is less often in the headlines. CDC lists breathing problems, feeding difficulties, cerebral palsy, developmental delay, and vision and hearing problems among longer-term risks, with severity rising as gestational age falls. A population analysis by Schieve and colleagues in the Annals of Epidemiology estimated that preterm birth and/or low birth weight account for roughly 55% of the population attributable fraction of cerebral palsy in U.S. children, and 10%-20% for autism spectrum disorder, intellectual disability, learning disability, and other developmental delay. Those are attributions of burden, not predictions for any one infant. Most late-preterm babies do not develop cerebral palsy, but they explain why prematurity prevention is also disability prevention.

Extremely preterm survivors carry the highest rates of chronic lung disease, retinopathy of prematurity, neurodevelopmental impairment, and rehospitalization. Late-preterm children have subtler risks: higher school-age learning problems and respiratory illness than full-term peers. The evidence base is stronger for very preterm cohorts in neonatal networks than for the much larger late-preterm group, where long-term data are thinner than the clinical volume would justify.

Families also absorb economic and mental-health aftershocks. A multi-week NICU stay disrupts employment and breastfeeding, along with bonding. Postpartum depression risk is elevated after complicated births; our postpartum depression statistics review that intersection. Prevention tools that work at the individual level are real but limited: low-dose aspirin for high preeclampsia risk, progesterone for selected prior spontaneous preterm birth or short cervix, smoking cessation, infection treatment, and careful multifetal management. None of those, applied only in clinic, will move a national rate stuck at 10.4% while structural drivers remain.

The patient at 34 weeks went home with a baby who needed an apnea monitor for a month and early-intervention therapy for a year. She is fine. Her child is in kindergarten and thrives. That outcome is common enough that it can hide the infants who do not follow that path, and the families still paying bills three years later. The national rate is a single number. The story under it is not.

Frequently asked questions about preterm birth

What is the U.S. preterm birth rate right now?

10.41% of live births were preterm in 2024, according to the National Center for Health Statistics, unchanged from 2023. March of Dimes reports the same year as 10.4% and counts 377,204 preterm births. Preterm means birth before 37 completed weeks of gestation on the obstetric estimate.

What grade did the United States get on the March of Dimes report card?

A D+ for the fourth consecutive year on the 2025 Report Card, which uses 2024 birth data. Half of states received a D or an F, and only 11 states met the Healthy People 2030 target of 9.4%. The letter grade is March of Dimes' scale; the underlying rates come from NCHS natality files.

How many preterm births are late preterm versus early preterm?

In 2024, late-preterm births (34-36 weeks) were 7.69% of all U.S. births, and early-preterm births (under 34 weeks) were 2.72%, per NCHS. Late preterm makes up most preterm deliveries, while early preterm concentrates the highest risks of death and long-term disability.

Are there racial disparities in preterm birth?

Yes. NCHS data for 2024 show a 14.86% preterm rate among non-Hispanic Black mothers versus 9.49% among non-Hispanic White mothers. American Indian and Alaska Native (12.59%) and Native Hawaiian and Other Pacific Islander (12.50%) rates also exceed the national average. The early-preterm gap is even wider.

How much does a NICU stay cost?

Among commercially insured newborns, the Health Care Cost Institute found average spending of $71,158 per NICU admission in 2021, with wide variation by severity. Lifetime societal cost of preterm birth was estimated at $25.2 billion for the 2016 U.S. birth cohort (about $64,815 per preterm birth) in a peer-reviewed update by Waitzman and colleagues.

What are the long-term effects of being born preterm?

Risks include chronic respiratory problems, vision and hearing impairment, developmental delay, and cerebral palsy, with severity rising as gestational age falls. Preterm birth and low birth weight account for roughly half of cerebral palsy cases at the population level in U.S. children, per Schieve et al. Most late-preterm infants do well; extremely preterm survivors need the closest long-term follow-up.