Charleston, W.Va. (AP) -- For the second consecutive year, West Virginia earned an F on a March of Dimes report card ranking states on the number of babies born prematurely.
The nonprofit group announced Tuesday that West Virginia had a preterm-birth rate of 13.9 percent in 2007, the most recent data available.
That's compared to 12.7 percent nationally, a d grade.
No state earned an a.
West Virginia earned accolades for reducing the percentage of uninsured women and lowering the rate of induced late preterm births.
Still, maternal smoking and lack of health insurance were cited as the two largest contributors to preterm births.
The report says about 38 percent of women of childbearing age in West Virginia smoke.
The percentage of women without insurance dropped to about 22 from 23.
(Copyright 2009 by the Associated Press. All rights reserved.)