Growth aberration in multiple pregnancy

Growth of twins and higher-order multiples is an exceptional metabolic challenge for the expecting mother. She is doing much more than a mother of a singleton in terms of nurturing, however. Metabolic requirements need adequate dietary intervention in the form of increased weight gain during early pregnancy. It is normal for multiples to be smaller than singletons. Being smaller than singletons does not necessarily mean that multiples are pathologically growth restricted. It is important to remember that twins and triplets have different growth patterns, and their growth should not be considered by using singleton standards. When a small-for-gestational-age fetus is suspected in a multiple pregnancy, it is advisable to follow or to treat the pregnancy as if it was an SGA singleton.