• Posted February 4, 2025

Heart Health At Risk For New Moms Of Twins

New moms who’ve just had twins run a high risk of heart disease in the coming weeks and months, a new study suggests.

Women have a doubled risk of hospitalization for heart problems within a year of delivering twins, researchers reported Feb. 3 in the European Heart Journal.

Their risk is even higher -- more than eightfold -- if they also had high blood pressure during their pregnancy. 

“The maternal heart works harder for twin pregnancies than for singleton pregnancies, and it takes weeks for the maternal heart to return to its pre-pregnancy state,” lead researcher Dr. Ruby Lin, a maternal-fetal medicine fellow at Rutgers Robert Wood Johnson Medical School in New Brunswick, N.J., said in a news release.

“People with twin pregnancies should be aware of the short-term increase in cardiovascular disease complications in the first year after birth, even if they had a pregnancy that was not complicated by high blood pressure conditions, such as preeclampsia,” Lin added.

For the study, researchers analyzed data on more than 36 million U.S. hospital deliveries that occurred between 2010 and 2020.

The hospital readmission rate for heart problems within a year of birthing twins was 1,105 per 100,000 deliveries, nearly double that for singleton pregnancies, 734 per 100,000.

All told, moms who gave birth to twins had a 95% increased risk of hospitalization for a range of heart problems, including heart disease, heart attack, stroke, heart failure, and irregular heart rhythm.

Moms who developed a high blood pressure condition during pregnancy had an even higher risk of severe heart problems, results show.

Among mothers of twins, women who had high blood pressure were more than eight times as likely to require hospitalization for heart problems, researchers said. 

Mothers of singletons were nearly six times as likely, if they had high blood pressure during pregnancy.

These results are extremely concerning given that “the rate of twin pregnancies worldwide has risen in recent decades, driven by fertility treatments and older maternal age,” senior researcher Cande Ananth, a professor of obstetrics, gynecology and reproductive sciences at Rutgers Robert Wood Johnson Medical School, said in a news release.

Ananth noted that previous studies had found no long-term increased risk of heart disease following a pregnancy with twins.

“This is counterintuitive to what we observe clinically when caring for patients with twin pregnancies,” Ananth said.

Lin offered some practice advice.

“For patients having fertility treatments, especially for those with other cardiovascular risk factors, such as older age, obesity, diabetes, high blood pressure or heart disease, patients should be advised that twin pregnancies may increase cardiovascular disease complications in the short term,” she said.

“Given these higher risks, healthcare providers and health insurance companies should continue to provide follow-up for up to a year after birth for high-risk pregnancies such as twin pregnancies,” Lin concluded.

More information

Johns Hopkins Medicine has more about pregnancy with twins.

SOURCE: European Heart Journal, news release, Feb. 3, 2025