Premature twins: Week by week twin gestation overview

Find out which challenges premature twins born at 28 to 37 weeks might be facing. Learn about special care, preterm labour, twin birth weight and how to cope.

By Kate Phillipa Clark

Once you’ve found out that you’re pregnant with twins, you might start worrying about giving birth prematurely. The risk of giving birth to premature twins is indeed higher than if you were pregnant with a singleton. Nevertheless, about half of women pregnant with twins give birth at term. It means that they give birth when they’re at least 37+0 weeks pregnant. This group is not expected to experience any complications related to prematurity. The other half gives birth prematurely.

How will my premature twins do?

Today most children born very preterm – from 28 weeks – survive in high-income countries. In low-income countries about half of babies born at or below 32 weeks die. WHO estimates that preterm birth was responsible for nearly 1 million deaths in 2015. Three-quarters of them could be saved with current, cost-effective intervention. Being born prematurely means that there are long term risks. There is a greater risk of being diagnosed with cerebral palsy, mental retardation, visual and hearing impairments, and more subtle disorders of different central nervous system functions, such as language disorders, learning disabilities, attention deficit-hyperactivity disorder and behavioral problems. How your babies will do is very dependent on the course of your pregnancy, and on how premature your babies are. It also depends on the individual babies and the care that they receive.  Consult your doctor or your Maternal-Fetal Medicine (MFM) physician, if you’re worried about giving birth to premature twins. 

 

Premature twins ….

 

 

born at 28 weeks
The vast majority of twins born at 28 weeks survive in high-income countries. However, you’re in for quite a long stay in the Neonatal Intensive Care Unit (NICU).

born at 29 weeks
Twins born at 29 weeks require treatment with oxygen, surfactant, and mechanical assistance to help them breathe. They’ll need help eating.

born at 30 weeks
In low-income countries about half of babies born at or below 32 weeks die. Twins born at 30 weeks need to be born in a medical facility equipped to deal with preterm babies. Proper medical care is essential. Your babies will need help breathing as well as eating. The NICU staff will guide you on how to start breast- or bottle feeding once your babies have developed their sucking reflexes.

born at 31 weeks
Twins born at 31 weeks will need help breathing and eating. It’s important that they gain weight and grow.

born at 32 weeks
Twins born at 32 weeks are considered moderate to late preterm, which means that you’ve hit a major milestone. They’re no longer considered born very preterm.

born at 33 weeks
Your babies have come far, but they still need to grow and gain more weight. The far majority of babies born at 33 weeks will need help breathing.

born at 34 weeks
Twins born at 34 weeks will probably need help to learn to regulate temperature and master eating, and some will have breathing issues.

born at 35 weeks
Twins born at 35 weeks may not need any medical treatment. They may be able to go straight to the maternity ward with you. In most cases they’re now able to breathe by themselves.

born at 36 weeks
Most babies have mature lungs by now. This means that your babies won’t need special help breathing, if they’re born. However, since babies develop at different rates, there are exceptions to this.

born at 37 weeks
Even though your twins are in the moderate to late preterm category, it’s very likely that they won’t need medical treatment. They may be able to go straight to the maternity ward with you.

About the Author

Kate Phillipa Clark

Kate Phillipa Clark has a bachelor in Journalism and an Executive Master in Corporate Communication. She is an identical twin and so is her father.