The researchers found that Predicting preterm birth among American mothers. Worldwide, preterm birth is a significant public health issue, so any method that can predict which pregnant women will deliver prematurely would be welcome. The purpose of this research was to create an easily accessible and implementable clinical model for predicting preterm birth. The information for this case-control study was taken from the 2018-2019 edition of the National Vital Statistics System (NVSS). Preterm birth risk factors were investigated using univariate and multivariate logistic regression analyses. Results were quantified using a 95% CI and odds ratio (OR). Accuracy, sensitivity, and specificity, as well as area under the curve (AUC), were used to gauge how well the models performed. The results Model establishment and external validation used data from 3,006,989 pregnant women in 2019 and 3,039,922 pregnant women in 2018. With a total of 3,006,989 pregnant women, 324,700 (10.8%) gave birth prematurely. Higher education level of pregnant women [bachelor (OR = 0.82; 95% CI, 0.81–0.84); a master or above (OR = 0.82; 95% CI, 0.81–0.83)], pre-pregnancy overweight (OR = 0.96; 95% CI, 0.95–0.98) and obesity (OR = 0.94; 95% CI, 0.93–0.96), and prenatal care (OR = 0.48; 95% CI, 0.47–0.50) were associated with a reduced risk of preterm birth, while age more than or equal to 35 years (OR = 1.27; 95% CI, 1.26–1.29), black race (OR = 1.26; 95% CI, 1.23–1.29), pre-pregnancy underweight (OR = 1.26; 95% CI, 1.22–1.30), pregnancy smoking (OR = 1.27; 95%CI, 1.24–1.30), pre-pregnancy diabetes (OR = 2.08; 95% CI, 1.99–2.16), pre-pregnancy hypertension (OR = 2.22; 95% CI, 2.16–2.29), previous preterm birth (OR = 2.95; 95% CI, 2.88–3.01), and plurality (OR = 12.99; 95% CI, 12.73–13.24) were related to an increased risk of preterm birth. The AUC and accuracy of the prediction model in the testing set were 0.688 (95% CI, 0.686–0.689) and 0.762 (95% CI, 0.762–0.763), respectively. In addition, a nomogram based on information on pregnant women and their spouses was established to predict the risk of preterm birth in pregnant women.