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The 2018 Premature Birth Report Card from March of Dimes revealed some frightening information ahead of World Prematurity Day, which is Saturday, Nov. 17. In 2017, the U.S. preterm birth rate increased for the third consecutive year, despite progress made in several areas.

If those findings don’t rattle you, consider that this means: Within the United States, more babies were born sooner than expected, with serious risks to their health. Even more frightening is that premature birth (and resulting health complications) is the largest cause of death in the first year of life in the United States; it is also the worldwide-leading cause of death of children under the age of five.

According to the March of Dimes, the nation’s leading maternal and infant health nonprofit, the overall preterm birth rate in the U.S. rose .08 percent in 2017 from the previous year. Though there has been no singular cause of preterm birth identified, a statement reads:

[R]esearch shows that chronic inequities and unequal access to quality health care do have a negative impact on these rates. These factors contribute to the reality that women of color are up to 50 percent more likely to deliver prematurely and their children can face a 130 percent higher infant death rate compared to white women.

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In the same statement, the March of Dimes calls out unequal access to maternity care, especially in more impoverished communities. To detail how these racial, ethnic and geographic disparities affect preterm birth, the organization’s Premature Birth Report Card breaks down each state’s demographics.

But the news isn’t all bleak. The March of Dimes also lauds areas in the U.S. which have made progress and outlines strategies proven to be successful. Of the work that remains, Stacey D. Stewart, president of March of Dimes, said in a statement:

We must all come together to take concrete, commonsense steps to reverse this alarming trend. Our country’s most important resource is human potential. That begins with ensuring every baby has the healthiest possible start in life, regardless of racial and ethnic background or their family’s income. By expanding proven programs and innovative solutions we can shift our health care system to improve treatment and preventive care for moms and lower the preterm birth rate. Birth equity is our goal; it can be reached.