West Virginia has received an F for premature births.

The lack of health insurance and maternal smoking were cited as the two largest contributors to premature births in West Virginia.

About 22% of mothers lack insurance and 38% of women of childbearing age smoke.

It is 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 says that West Virginia had a preterm-birth rate of 13.9 percent in 2007, their most recent data.

Still, West Virginia has earned accolades for reducing the percentage of uninsured women and lowering the rate of induced late preterm births.

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