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Multifetal gestation and long-term maternal health
Uri Amikam1, Omri Dominsky1, Nir Melamed2
1Department of Obstetrics and Gynecology, Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
American Journal of Obstetrics & Gynecology MFM
|June 30, 2026
Summary
Multifetal pregnancies increase cardiovascular and metabolic stress, but do not raise long-term mortality risk. Complications like preeclampsia in twin pregnancies may have different long-term impacts than in singleton births.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Cardiovascular Health
Background:
- Multifetal gestations (e.g., twin pregnancies) significantly increase maternal cardiovascular and metabolic stress compared to singleton pregnancies.
- This heightened stress leads to higher rates of hypertensive disorders and gestational diabetes mellitus, alongside postpartum vulnerability.
- While acute risks are elevated, long-term cardiovascular mortality is not increased by multifetal gestation itself.
Purpose of the Study:
- To evaluate the long-term cardiovascular and metabolic health implications of multifetal gestations.
- To compare the prognostic significance of pregnancy complications in multifetal versus singleton pregnancies.
- To identify knowledge gaps in understanding long-term maternal health outcomes for multifetal pregnancies, especially those conceived via assisted reproductive technology.
Main Methods:
- Analysis of large population-based cohort studies.
- Comparison of long-term cardiovascular disease risk between women with multifetal and singleton gestations.
- Examination of the differential impact of pregnancy complications (preeclampsia, gestational diabetes) based on gestation type.
Main Results:
- Twin pregnancy is not independently associated with increased long-term cardiovascular disease after adjusting for complications.
- Preeclampsia and gestational diabetes in twin pregnancies confer a lower risk of future cardiovascular disease and diabetes, respectively, compared to singletons.
- Higher rates of pelvic floor stress and urinary incontinence are noted in twin pregnancies, with long-term outcomes requiring further study.
Conclusions:
- Multifetal gestation poses acute maternal risks but does not increase long-term cardiovascular mortality.
- Pregnancy complications in multifetal gestations have different long-term prognoses than in singleton pregnancies.
- Further research is needed on assisted reproductive technology pregnancies and extended postpartum cardiometabolic follow-up.
Keywords:
cardiovascular diseasegestational diabeteslong-term maternal healthmultifetal gestationosteoporosispelvic floor disorderspreeclampsiatwin pregnancyMore Related Videos
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