Objective: To examine the relationship of individual and composite number of unmet basic needs (housing, energy, food, and healthcare hardships) in the past year with preterm birth status among children aged 0–24 months.

Study Design: We examined cross-sectional 2011–18 data of 17,926 families with children aged 0–24 months. We examined children born <31 weeks’, 31–33 weeks’, and 34–36 weeks’ gestation versus term (≥37 weeks) using multivariable multinomial logistic regression.

Results: At least 1 unmet basic need occurred among ≥60% of families with preterm children, compared to 56% of families with term children (p = 0.007). Compared to term, children born ≤30 weeks’ had increased odds of healthcare hardships (aOR 1.28 [1.04, 1.56]) and children born 34–36 weeks’ had increased odds of 1 (aOR 1.19 [1.05, 1.35]) and ≥2 unmet needs (aOR 1.15 [1.01, 1.31]).

Analysis: Unmet basic needs were more common among families with preterm, compared to term children.