Twin Prematurity: Reasons and Risks of Premature Twin Birth

Any birth that occurs more than three weeks before the baby’s anticipated due date is considered to be a premature birth. When it comes to twin pregnancies, premature birth is a condition that occurs rather frequently. It is estimated that premature birth affects about half of the twin pregnancies. Twins born prematurely can have a variety of health complications. As a consequence of this, premature twins are in need of specialized care from their mother as well as other medical professionals in order to survive and live a healthy life.

Twin Pregnancy Duration

As per NICHD, a pregnancy is considered full-term at 39 weeks. Again, according to, any baby born before 37 weeks is considered premature. As twins usually arrive at 35 to 37 weeks they are often born prematurely.

Twin Pregnancy Duration

Why Are Twins Born Prematurely?

There are many reasons as to why more twins are born prematurely than singleton babies. Firstly, in many cases, the mother goes into labor spontaneously without any prior signals.

The reason for this is still unknown and as a consequence, it is very hard to prevent early delivery in such cases. Secondly, There are situations when health concerns of the mom or the babies force doctors to deliver babies earlier than anticipated.

Why Are Twins Born Prematurely

Other risk factors for premature birth include pre-eclampsia, pre-existing diabetes or gestational diabetes, high blood pressure, etc according to Raising Children Network.

Health Risks of Prematurely Born Twins

Health Risks of Prematurely Born Twins

Premature twins typically weigh less than 5 pounds after being born, which is considered a low birth weight. This increases the likelihood of a wide variety of serious health problems. 

Some of these problems are short-term. During the first weeks of birth, short-term complications of premature birth may include-

Breathing Problems

Because of an undeveloped respiratory system, premature twins may have difficulty breathing. If the baby’s lungs are deficient in surfactant, they may develop respiratory distress syndrome because the lungs are unable to expand and contract appropriately. They might also develop other lung conditions like bronchopulmonary dysplasia and apnea. 


Premature babies are more likely to develop blood disorders such as anemia. Anemia is a frequent disorder in which the body lacks sufficient red blood cells. While all newborns have a steady loss in red blood cell count throughout the first few months of life, preterm babies may experience a greater drop.


Neonatal Jaundice is another common health problem in newborns in general. This is even more prevalent in premature babies. Due to an excessive amount of bilirubin in the blood, newborn babies get yellow discoloration in their skins and eyes. 

Other than these, brain problems, immune system issues, gastrointestinal problems, etc are some of the short-term complications of premature twins according to Mayo Clinic. On the other hand, premature twins can also have lasting health complications such as cerebral palsy, intellectual disability, vision and hearing loss, feeding problems, etc as cited in URMC.

How Long Will Your Preemie Twins Stay in The NICU?

Most premature babies are admitted to a Neonatal Intensive Care Unit (NICU) due to the potential health concerns mentioned above. During this time the doctors and other health care professionals monitor the babies 24/7. Even though this period can be worrying for the parents, research shows that premature twins survival rate is positively high.

How long your twins will need to be in the NICU will depend on how early they were born and what health complications they have. According to Mayo Clinic, premature babies are divided into categories depending on how early they were born. 

Babies that were born before or at 25 weeks of pregnancy are categorized as extremely preterm babies. They are typically discharged two to three weeks prior to their due date Unless there are other health issues.

How Long Will Your Preemie Twins Stay in The NICU

Babies who are born at less than 32 weeks of pregnancy are categorized as very preterm babies. Such twins will typically stay in the NICU till around their original due date.

Babies born between 32 weeks to 34 weeks of pregnancy are in the moderately preterm category. Again, Babies born between 34 weeks to 36 weeks are categorized as late preterm babies. These babies will be discharged in a few days or weeks. They are typically thought to be in a non-critical state.

How to Care for Your Preemie Twins While in The NICU?

How to Care for Your Preemie Twins While in The NICU

Having to see your newborns in the NICU must be a stressful situation. The frustration and the helplessness the parents go through are unimaginable. However, you can do certain things to take care of your preemies while they remain in the NICU. 

The best course of action would be to consult with attending physicians and nurses about what you can and cannot do as soon as possible. There is a good probability that you will be able to touch your babies and breastfeed them if they are not in a serious condition.

You can also assist them with clothing and changing their diapers. In addition to that, you can be of assistance to your twins by washing their clothes at home with gentle detergents.

Another important way in which you can help your babies is by pumping breast milk for them. Breast milk is very necessary for the development of premature babies because it includes essential nutrients that aid in infection prevention and growth. This is why even if you cannot breastfeed your twins, you can get them to drink it using a breast pump and baby bottle.

How to Care for Your Preemie Twins While in The NICU

Again, it is very important to create bonding experiences with your newborns in the first few weeks after their birth. If you cannot take your babies home, it is essential that you bond with them while they are in the NICU. In this regard, you can talk to the hospital staff and then proceed to personalize their cribs with pictures, stuffed animals, and other comfort items as a part of the bonding process.


It is a pretty normal occurrence in twin pregnancies, despite the fact that premature twins come with their own set of complications. In addition, the majority of the complications are very short-term, and the survival rate of premature twins is relatively high. With the appropriate medical care and assistance, your premature twins can live healthy and normal life.

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