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Multiples: Risks to the Fetus & Baby

The biggest risk associated with carrying multiples is preterm labor. Mothers of multiples are twice as likely to experience this as mothers of singletons. Preterm labor can often be managed or even eliminated if the situation is addressed quickly by a doctor.

Premature Babies

Due to preterm labor and other complications, many multiples are born prematurely and with low birth weight. Twins and higher order multiples are six times more likely to be born prematurely than a single baby. This affects newborns in a wide variety of ways medically and developmentally. They may need help eating, breathing and fighting infection. Premature babies are more likely to experience long-term problems such as intellectual and developmental disabilities, cerebral palsy, vision loss, and hearing loss. Fortunately, science has advanced to a point where often these babies can be treated to overcome the disadvantages associated with arriving too soon.

Other Potential Risks

During a multiple pregnancy there is a risk of intrauterine growth restriction (IUGR), a condition where the babies are smaller than they should be at a given stage of development. Multiple gestations grow at approximately the same rate as a singleton pregnancy up to a certain point. The growth rate of twin pregnancies begins to slow at 30 to 32 weeks. Triplet pregnancies begin slowing at 27 to 28 weeks, while quadruplet pregnancies begin slowing at 25 to 26 weeks. IUGR occurs because the placenta cannot handle the additional growth and because the babies are competing for nutrients. Doctors carefully monitor the growth of multiple babies by ultrasound and by measuring the mother’s abdomen to detect such problems as early as possible.

Intrauterine fetal demise, a term to describe a baby that has died in utero, is extremely uncommon. However, if it does occur, your healthcare provider will determine whether to proceed with delivery. He or she will evaluate the risks of having a premature baby versus the risks of remaining in utero.


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