Babies on Board? The Joys and Risks of Multiple Gestation

Throughout time, people have been fascinated by twins. Literature and art have long explored the complex relationship of many twins. From a scientific standpoint, identical twins have been studied to resolve the “nature versus nurture” debate. For many, triplets and quadruplets spark an even greater interest due to their relative rarity. We will be discussing the joys and risks of multiple gestation.

Are Twins More Common Now?

Scientists have confirmed that twin birth rates have increased over the past three decades. Based on a recent study, twin birth rates increased by 42 percent from 1980 to 2015. This increase in twin birth rates has been attributed to use of assisted reproductive technology, such as IVF, as well as the trend of having children later in life. This increase in twin birth was most pronounced in high-income countries. In North America, there was a 71 percent increase in twin birth rate during this same timeframe. In Europe, a 58 percent increase in twin gestation has been documented.

Will The Trend Continue?

Many researchers opine that the “twin trend” may decrease over time. Specifically, advances in IVF and other assisted reproductive technology may decrease the need for transfer of multiple embryos. In turn, the likelihood of multiple gestation from IVF is expected to go down. Of note, the incidence of increased twin gestation between 1980 and 2015 was only seen in fraternal twins. The incidence of identical twin birth has remained steady.

What Are the Risks of Twins, Triplets, Quadruplets and More?

There are several potential complications of multiple gestation. One main concern is preterm labor and birth. Over 60 percent of twins and nearly all higher order multiples are born prior to 37 weeks. The risk of prematurity increases with the number of fetuses. Gestational hypertension and miscarriage are additional issues in the setting of multiple gestation. In some cases, twin-to-twin transfusion syndrome is possible. Additionally, multiple birth babies have approximately twice the risk of congenital defects, including neural tube defects and heart abnormalities.

What Are the Positives of Multiple Gestation?

For many families, a multiple gestation makes their family “complete”. Some women report relief in having a “two-for-one” deal (two children but only one pregnancy). Additionally, the bond between multiple gestation babies can be beautiful. Many parents report joy that their babies have a permanent friend to navigate life with.

Takeaway Message:

The incidence of multiple gestation has increased over the past 30 years. Researchers attribute this to the increase in IVF and trend towards childbirth later in life. There are several potential risks that come with a multiple gestation. However, parents of multiples often report special joy that comes from this experience. Women who are pregnant with multiples should be encouraged to discuss their concerns with their provider.