Increased Heart Disease Risk for Mothers of Twins Post-Delivery

Mon 3rd Feb, 2025

Recent research has identified that mothers of twins face a significantly elevated risk of heart disease during the year following childbirth, as reported in the European Heart Journal. The findings indicate that these mothers are twice as likely to be hospitalized for heart-related conditions compared to those who have had single births. This risk is even more pronounced among mothers who experienced high blood pressure during their pregnancies.

The study, conducted by a team from Rutgers Robert Wood Johnson Medical School, focused on a comprehensive analysis of data from 36 million hospital deliveries across the United States between 2010 and 2020. Researchers categorized the participants into four distinct groups: mothers of twins with normal blood pressure, mothers of twins with hypertensive disorders, mothers of singletons with normal blood pressure, and mothers of singletons with hypertensive disorders.

Hypertensive disorders during pregnancy encompass conditions such as gestational hypertension, pre-eclampsia, and eclampsia. The research team calculated the readmission rates to hospitals for various cardiovascular diseases, including heart attacks and strokes, within one year of childbirth.

The results revealed that the readmission rate for cardiovascular issues was significantly higher for mothers of twins, standing at 1,105.4 per 100,000 deliveries, compared to 734.1 per 100,000 for single births. Notably, mothers of twins with normal blood pressure had nearly double the likelihood of hospitalization for heart-related ailments. For those with high blood pressure during pregnancy, the risk surged to more than eight times higher than that of their singleton counterparts.

Interestingly, while the immediate risks post-delivery are higher for mothers of twins, the long-term mortality rates appear to favor them compared to mothers of singletons with high blood pressure conditions. This suggests that the risks associated with twin pregnancies may diminish over time, whereas mothers of singletons may face additional, underlying cardiovascular risks.

Dr. Ruby Lin, a maternal-fetal medicine fellow at the university and lead author of the study, emphasized that the cardiovascular system of a mother undergoes considerable strain during a twin pregnancy. It can take weeks for the heart to revert to its pre-pregnancy condition. Consequently, it is vital for women expecting twins to be aware of the heightened risk for heart complications in the year following childbirth, even if their pregnancy was not complicated by hypertensive disorders.

Healthcare providers are urged to closely monitor mothers of twins for up to a year postpartum, especially for those with pre-existing cardiovascular risk factors such as obesity, diabetes, and hypertension. The need for comprehensive postpartum care is becoming increasingly apparent in light of the growing incidence of maternal mortality due to cardiovascular diseases.

An editorial accompanying the study highlighted the importance of identifying risk factors for cardiovascular disease during pregnancy, amidst rising maternal morbidity rates in the United States. It noted that twin pregnancies, which account for about 3.1% of all births, present unique challenges and warrant further investigation to enhance maternal health outcomes.

As healthcare professionals strive to reduce postpartum complications and improve care quality, collaboration across various specialties is essential to tackle the challenges posed by twin pregnancies and their associated risks.


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