Health & Pregnancy

Risks Linked With Twin Births

No pregnancy is entirely free of risks. But carrying twins can put you and your babies at increased risk for certain pregnancy-related complications, including premature birth and diabetes. Don't let this alarm you. With good prenatal care, you can greatly increase your chances of enjoying a healthy pregnancy and healthy babies.

What Are My Risks?

With twins, you're at greater risk for:

Premature birth. Twins are born prematurely more than half the time. That's before the end of 37 weeks of pregnancy. Premature babies may have health problems as newborns. Sometimes they also have lasting disabilities.

Low birth weight (LBW). More than half of twins are born with LBW, weighing less than 5 1/2 pounds. LBW babies are at increased risk of health problems after birth, such as:

• Vision and hearing loss
• Mental disabilities
• Cerebral palsy

However, know that this is more likely if babies are born before 32 weeks or weighing less than 3 1/3 pounds.

Twin-twin transfusion syndrome (TTTS). This condition affects about 10% of identical twins, who share a placenta. TTTS develops when a connection between the babies' blood vessels allows one baby to get too little blood and the other too much. A doctor can treat TTTS with laser surgery to seal off the vessel connection or with amniocentesis to drain excess fluid.

Preeclampsia. You are more than twice as likely to develop preeclampsia than women carrying one baby. Preeclampsia is marked by:

• High blood pressure
• Protein in the urine
• Swelling

If you have this, it may require strict bedrest at home or in the hospital. You may also need early delivery to prevent serious complications. If not treated, preeclampsia can deprive your baby of oxygen and nutrients and can damage your organs.

Gestational diabetes. If you develop diabetes (high blood sugar) during pregnancy, your babies may grow too big. Delivering big babies increases your risk of complications during delivery, and may require you to deliver by cesarean. Your babies may also have breathing problems when they are born. But you can take steps, such as with diet, to lower your risk.

Iron deficiency anemia. A lack of healthy red blood cells from too little iron can lead to premature birth. Be sure to add iron to your diet as recommended by your doctor.

Yes, these are serious risks, but try not to worry too much. With good prenatal care, you and your doctor can lower your risk and spot any problems earlier, rather than later. Then you can work with your doctor to manage and minimize the impact of any complications.

How Can You Lower Your Risk?

Here are six tips to help you and your twin babies thrive.

1. See your doctor regularly. You may need to see your doctor twice a month during the second trimester and weekly (or more often) during the third trimester. Get regular ultrasounds and other tests as your doctor suggests.
2. Eat a healthy, well-balanced diet. You probably will need to eat about 2,700 calories per day if you were of normal weight before pregnancy. But talk to your doctor to find out what is right for you. Make sure calcium, folic acid, iron, and protein are a part of your diet.
3. Take prenatal vitamins containing iron and folic acid as recommended by your doctor.
4. Maintain a healthy weight. Talk to your doctor to find out what's right for you.
   If you were of average weight before pregnancy, try to gain about 35 to 45 pounds while carrying twins (about 1 pound per week during the first half of pregnancy, and a little more than a pound a week during the second).
   If you were overweight before pregnancy, try to gain less.
   If you were underweight, you should gain more.
5. Be kind to yourself. Rest when you feel tired, try not to overdo it, and take time to relax and unwind.
6. Cut back on activities. Help prevent preterm labor by cutting back on activities around the 20th to 24th weeks of pregnancy. Or do this sooner, if your doctor advises you to.

This is an exciting and stressful time in life. And although complications can arise during pregnancy with twins, don't let it discourage you. Talk to your doctor about your concerns. Together you can create a plan that can help to ensure you have a healthy pregnancy and deliver healthy babies.