Twin pregnancies in women with heart disease are complicated by high risk of heart failure: data from the EORP ROPAC Registry
Authors' conclusion
Women with heart disease and a twin pregnancy have twice the risk of heart failure, particularly in those with a prior diagnosis of cardiomyopathy.
Study context
- Population
- Pregnant women with heart disease
- Participants
- 96 vs 5,643
- Exposure
- Pregnancy outcomes in twin vs singleton pregnancies
- Twinn = 96
- Singletonn = 5,643
- Outcome
- Maternal age at baseline
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Prior cardiac interventions · fewer in twin mothers
P = 0.02
Heart failure · significantly higher in twin pregnancies
P < 0.001
Maternal mortality, arrhythmia, endocarditis, thrombosis, dissection, acute coronary syndrome, hospital admission for cardiac reasons
- No differences
Risk factors for heart failure (multivariable analysis)
- Twin pregnancy was a risk factor for heart failure in the whole ROPAC population
- Within twin pregnancies, cardiomyopathy and prior heart failure were risk factors for heart failure
Timing of heart failure by diagnosis
- Valvular or congenital heart disease: heart failure during pregnancy; cardiomyopathy: during the peripartum period
Obstetric outcomes
- Worse in twins
Original publication
Twin pregnancies in women with heart disease are complicated by high risk of heart failure: data from the EORP ROPAC Registry. Heart. Published 23 October 2025. doi:10.
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