Rates of infant mortality and preterm birth in the U.S. are among the highest of any industrialized nation and significant disparities in rates exist by maternal characteristics. This study examines singleton preterm birth rates from 2012-2018 by rurality and census region using birth certificate data from the National Center for Health Statistics.

The data showed preterm singleton birth rates were consistently higher in rural versus urban areas across all race and ethnic groups, payment sources for delivery, and persons participating in the Women, Infants, and Children program. The increased risk for infant and maternal mortality and morbidity in rural areas highlights the importance of health assistance programs for pregnant women, mothers, and children in these rural communities.