Reporters Without Borders has dropped the United States to No. 45 in its annual ranking of press freedom for 180 countries around the world.

In the report released Wednesday, the United States received a "fairly good" rating, which falls below the category of "good," in which only 9 percent of countries rated were placed.

The ranking continues a downward trend for the U.S. in recent years. The country finished No. 43 in 2017 and No. 41 in 2016.

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The report pins part of the blame for the U.S. slide on President Trump Donald John TrumpOmar fires back at Trump over rally remarks: 'This is my country' Pelosi: Trump hurrying to fill SCOTUS seat so he can repeal ObamaCare Trump mocks Biden appearance, mask use ahead of first debate MORE and his regular attacks on the media. The president often uses the term "fake news" in describing the American media.

"The United States, the country of the First Amendment, has fallen again in the Index under Donald Trump, this time two places to 45th," the report says. "A media-bashing enthusiast, Trump has referred to reporters 'enemies of the people,' the term once used by Joseph Stalin."

"The U.S.' decline in press freedom is not simply bad news for journalists working inside the country; the downward trend has drastic consequences at the international level," the report noted. " 'Fake news' is now a trademark excuse for media repression, in both democratic and authoritarian regimes."

Norway and Sweden were ranked at the top for press freedom for the second straight year, while North Korea, Eritrea, Turkmenistan, Syria and China were ranked at the bottom.

The report notes that attacks on the media are "no longer limited to authoritarian countries" and that "democratically-elected leaders" no longer see the media as essential.

"Hostility towards the media from political leaders is no longer limited to authoritarian countries such as Turkey (down two at 157th) and Egypt (161st), where 'media-phobia' is now so pronounced that journalists are routinely accused of terrorism and all those who don’t offer loyalty are arbitrarily imprisoned," the report says.

"More and more democratically-elected leaders no longer see the media as part of democracy's essential underpinning, but as an adversary to which they openly display their aversion."

Trump has regularly railed against media outlets, including CNN, The New York Times and The Washington Post.

In January, the president launched the fake news "awards" online, with CNN, The New York Times, The Washington Post and Newsweek being named surrounding particular stories, among other outlets.

"2017 was a year of unrelenting bias, unfair news coverage, and even downright fake news," the announcement read on Jan. 17. "Studies have shown that over 90 percent of the media’s coverage of President Trump is negative."