Risks Linked With Twin Births

Medically Reviewed by Stephanie S. Gardner, MD on April 26, 2022
3 min read

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.

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 36 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:

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 amniotic fluid.

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

  • High blood pressure
  • Swelling
  • Headache
  • Vision changes

If you have this, you may 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 and low blood sugar 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.