A March of Dimes report rated North Dakota and 22 other states poorly in premature birth rates.

The report, released today, assigned letter grades to states on their progress toward Healthy People 2010 objectives. North Dakota received a D.

"The leading cause of infant mortality is pre-term birth," said Melany Jenkins, the associate director program services with the North Dakota chapter of March of Dimes. March of Dimes is a nonprofit organization that tries to reduce premature birth, infant mortality and birth defects through education and research.

Healthy People 2010 is a continuation of efforts by the U.S. Department of Health and Human Services to improve conditions mentioned in a 1979 Surgeon General's report. The premature birth rate is part of the health indicators tracked in Healthy People 2010.

The report looked at the percent of uninsured women, percent of women who smoke and the percent of births between the 34- and 36-week gestation. The highest grade was given to Vermont, which was a B. Eight states earned a C and 18 states, Puerto Rico and the District of Columbia rated an F.

"We're probably just doing OK," said Kim Senn, director of the division of family health in the North Dakota Department of Health.

The rate of premature births in North Dakota is 11.5 percent, which is lower than the national average of 12.7 percent. The goal for Healthy People 2010 is to have a 7.6 percent premature birth rate. The rate in North Dakota is stable, Senn said.

The state operates a program to improve the chance of a woman giving birth to a healthy baby at term. The Optimal Pregnancy Outcome Program operates from eight sites in the state. It provides a woman with nutrition advice, visits with a nurse and a social worker.

The program is available to women regardless of health insurance coverage. The rate of uninsured women in North Dakota is 14.3 percent. This could change because of the cost-cutting measures some businesses might make because of the economy. Also, as people are strained financially, paying for coverage could become a lower priority.

"Unfortunately, health care is where some people choose to make cuts," Senn said.

The health department also is working with tobacco prevention to reduce smoking among women. In North Dakota, 24.4 percent of women reported smoking while pregnant. The numbers are self-reported, and could be higher, Jenkins said.

This is the first year for the premature birth report card. The March of Dimes hopes to make it an annual report.

(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@;bismarcktribune.com.)