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We read with interest the research letter by Douglas and colleagues, ‘Disparities in health outcomes of infants born to teenage birthing individuals: a cross-sectional study’.1 The investigators analysed 2019 data from the US Centers for Disease Control and Prevention’s (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) database to describe birth outcomes among 1395 teenaged individuals representing 72 795 in the weighted sample. They specifically analysed associations of race with preterm birth (PTB, <37 weeks’ gestation), early PTB (<34 weeks) and low birth weight (<2500 g). Non-Hispanic black individuals had significantly higher odds of early PTB compared with non-Hispanic white individuals, but the association with all PTBs was not significant (adjusted OR 1.14, 95% CI 0.58, 2.23). They also looked for protective factors and found, somewhat surprisingly, that public insurance, typically a proxy for lower socioeconomic status, was associated with lower odds of each outcome compared with private insurance. They also found that higher education was associated with lower odds of early PTB.