How being pregnant with multiples can affect your health

Premature birth (birth before 37 weeks of pregnancy) is the most common complication of being pregnant with multiples. In fact, If you’re pregnant with multiples, you’re 6 times more likely to have your babies early than if you’re pregnant with one baby.

How can a multiple pregnancy affect your health?

If you’re pregnant with multiples, you’re more likely than if you were pregnant with one baby to have complications, including:

  • Preterm labor: This is labor that happens too early, before 37 weeks of pregnancy.
  • Anemia: Anemia is when you don’t have enough healthy red blood cells to carry oxygen to the rest of your body. You may have anemia if your body isn’t getting enough iron. A condition called iron-deficiency anemia is common in multiple pregnancies and can increase your chances of premature birth. Your provider may prescribe an iron supplement for you to make sure you’re getting enough iron.
  • Gestational diabetes: This is a kind of diabetes that only pregnant women can get. If untreated, it can cause serious health problems for you and your babies. Diabetes is when you have too much sugar (called blood sugar or glucose) in your blood.
  • Gestational hypertension or preeclampsia: These are types of high blood pressure that only pregnant women can get. High blood pressure is when the force of blood against the walls of your blood vessels is too high. It can cause problems during pregnancy. Preeclampsia is a condition that can happen after the 20th week of pregnancy or right after pregnancy. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly.
  • Hyperemesis gravidarum: This is a severe kind of morning sickness or nausea and vomiting of pregnancy (also called NVP).
  • Polyhydramnios: This is when you have too much amniotic fluid. Amniotic fluid is the fluid that surrounds your baby in your uterus (womb).
  • Miscarriage or stillbirth: Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy. Some women who are pregnant with multiples have a condition called vanishing twin syndrome. This is when one or more babies die in the womb, but one baby survives.

If you’re having multiples, you’re more likely to have these complications after giving birth:

  • Postpartum depression (also called PPD): This is a kind of depression that some women get after having a baby. PPD is strong feelings of sadness that last for a long time. These feelings can make it hard for you to take care of your baby.
  • Postpartum hemorrhage: This is heavy bleeding after giving birth. It’s a serious but rare condition.

How can being pregnant with multiples affect your babies’ health?

If you’re pregnant with multiples, your babies are more likely to have health complications, including:

  • Premature birth: Premature babies (born before 37 weeks of pregnancy) may have more health problems or need to stay in the hospital longer than babies born later. Some may spend time in a hospital’s newborn intensive care unit (also called NICU). This is the part of a hospital that takes care of sick babies. Premature babies also may have long-term health problems that can affect their whole lives. More than half of twins and nearly all triplets and other higher-order multiples are born prematurely. The earlier in pregnancy your babies are born, the more likely they are to have health problems.
  • Birth defects: Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works. Multiples are about twice as likely as singleton babies to have birth defects, including neural tube defects (like spina bifida), cerebral palsy, congenital heart defects and birth defects that affect the digestive system. The digestive system helps your baby’s body process food.  
  • Growth problems: Multiples are usually smaller than singleton babies. Your provider can use ultrasound to check your babies’ growth at prenatal care checkups. When one twin is much smaller than the other, they’re called discordant twins. Discordant twins are more likely to have health problems during pregnancy and after birth.
  • Low birthweight (also called LBW): This is when your baby is born weighing less than 5 pounds, 8 ounces. Babies with LBW are more likely than babies born at a normal weight to have certain health problems, like retinopathy of prematurity. They’re also more likely to have health problems later in life, like high blood pressure. More than half of twins and nearly all higher order multiples are born with LBW.
  • Twin-twin transfusion syndrome (also called TTTS): This condition happens when identical twins share a placenta and one baby gets too much blood flow, while the other baby doesn’t get enough. The placenta grows in your uterus (womb) and supplies your babies with food and oxygen through the umbilical cord. TTTS can be treated with laser surgery to seal off the connection between the babies’ blood vessels and amniocentesis (also called amnio) to drain off extra fluid.
  • Neonatal death: This is when a baby dies in the first 28 days of life. Premature birth is the most common cause of neonatal death.

Are you more likely than other women to get pregnant with multiples?

You may be more likely than other women to get pregnant with more than one baby if:

  • You have fertility treatment: If you’re having fertility treatment, it’s important to try to get pregnant with just one baby. For example, if you’re having a treatment called in vitro fertilization (also called IVF), you can have just one embryo placed in your uterus. This is called single embryo transfer (also called SET). In IVF, an egg and sperm are combined in a lab to create an embryo (fertilized egg) which is then put into your uterus. If you’re having any kind of fertility treatment, talk to your provider about ways to help lower your chances of getting pregnant with multiples.
  • You’re in your 30s, especially your late 30s: If you’re 30 or older, you’re more likely than younger women to release more than one egg during a menstrual cycle (also called your period).
  • You have a family history of multiples: Family history is a record of health conditions and treatments that you, your partner and everyone in your families has had. If you or other women in your family have had fraternal twins, you may be more likely to have twins, too. You’re also more likely to have multiples if you’ve been pregnant before, especially if you’ve been pregnant with multiples.   
  • You’re obese: If you’re obese, you have an excess amount of body fat and your body mass index (also called BMI) is 30 or higher. To find out your BMI, go to
  • You’re black or Caucasian: Black women are more likely to have twins than other women. Caucasian women, especially those older than 35 years old, are most likely to have higher-order multiples.

About the author:

March of Dimes is the leading nonprofit organization for pregnancy and baby health. For more than 75 years, moms and babies have benefited from March of Dimes research, education, vaccines, and breakthroughs. For the latest resources and health information, visit and

© 2017 March of Dimes Foundation
Originally posted 4.17

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