The U.S. gets a D+ grade for high pre-term birth rates, for the second year in a row.

Pre-term births are the leading cause of infant deaths in the U.S.

The mortality rate of babies born earlier than 37 weeks was 10.4% last year, according to a March of Dimes report.

The pre-term birth rate for New York was 9.5%. It was 9.1% in Massachusetts and 8.8% in Vermont.

Among the factors that can raise a mother’s risk of delivering pre-term are: smoking, high blood pressure, being overweight and having diabetes.