One of the most important complications of a multiple birth is the risk of premature delivery – delivery before 37 weeks of pregnancy. A spontaneous premature delivery is generally the result of premature labour pains, but can be caused if the waters break too early.

The chance of a premature birth is greatly increased in a triplicate or greater multiple birth, but twins are often born earlier than the usual 40 weeks (37 – 42 weeks) of a singleton birth. A child that is born too soon is called a premature baby.

Sometimes labour is induced prematurely because the gynaecologist decides the babies have a better chance outside the womb than in. This can occur if the babies are at risk of severe growth deficiency or the mother is in danger as a result of very high blood pressure. A paediatrician will always be involved in the decision to induce premature delivery A difficult balance will always have to be struck between the risks of allowing the pregnancy to continue and the risks associated with premature birth.

A premature birth entails a significant risk for the babies, depending on its timing. The lungs and other organs may not be fully developed, for example, which can lead to problems after the birth. Corticosteroids are often given to women at risk of premature birth in order to accelerate the development of the babies. In addition, premature babies often have a lower birth weight and their chances of survival are lower.

If labour pains cannot be slowed down in the case of a pregnancy of less than 30 – 32 weeks), the woman is usually transferred to a specialist centre that has a neonatal intensive care unit, or NICU. Intensive care can be provided in a centre of this type.