When pregnant with twins, you may be at higher risk for the following:

Preterm birth: More than half of twins are born before 36 weeks of pregnancy. Premature babies may face health problems at birth and sometimes have long-term disabilities.

Low birth weight (LBW): Over 50% of twins are born weighing less than 5½ pounds, which can lead to health issues such as vision and hearing problems, intellectual disabilities, and cerebral palsy—especially if they are born before 32 weeks or weigh less than 3½ pounds.

Twin-to-Twin Transfusion Syndrome (TTTS): This condition affects about 10–15% of identical twins who share a placenta. In TTTS, the connection between the babies’ blood vessels causes one twin to receive too much blood while the other receives too little. TTTS can be treated with laser surgery or amniocentesis.

Preeclampsia: Women carrying twins are more than twice as likely to develop preeclampsia, which is characterized by high blood pressure, swelling, headaches, and vision changes. Early delivery may be required to prevent serious complications.

Gestational diabetes: High blood sugar during pregnancy can cause your babies to grow too large, increasing the risk of delivery complications and possibly requiring a cesarean section. Your babies may also have breathing difficulties and low blood sugar at birth.

Iron-deficiency anemia: A shortage of healthy red blood cells due to low iron levels can lead to preterm birth. It’s important to include iron supplements in your diet as recommended by your doctor.