About the Centre

Why Twins?

Twin pregnancies are roughly five times more likely to be complicated by preterm birth, preeclampsia, fetal growth restriction, and other complications, compared with single-baby pregnancies. These complications can result in a considerable risk of the mom and baby being seriously ill or even dying.

Twin infants are about five times more likely to die by their first birthday than “singleton pregnancies”, or pregnancies where the mom is carrying one baby. Twin infants also comprise a disproportionate portion of neonatal intensive care admissions and have quadruple the risk of developing cerebral palsy.

There is an urgent need to promote research in the field of twin pregnancies to increase our understanding of how and why these pregnancy complications occur in twin pregnancies, and to develop treatment and care plans to decrease the risk of complications.

The research conducted by Sunnybrook’s Twins Research Centre will have a profound impact on both the short and long-term health of twin infants and their mothers.

The Twins Clinic

A woman expecting more than one baby will require special care during her pregnancy to prevent or manage any issues that may arise. Sunnybrook is home to Canada’s first and largest specialized clinic for multiple births. Our highly trained team delivers approximately 200 twins or triplets each year. As an academic health sciences centre, we are committed to improving care for multiples, which are considered high-risk pregnancies.

Potential risks increase with each additional fetus within the multiple birth pregnancy, so the need for frequent, intensive, prenatal care is of the utmost importance. Because of this, Sunnybrook has a health care team of medical professionals with extensive experience delivering multiples. The clinic values family-centred care, informed decision-making and respect for individual choices.

Nir Melamed is the Head of Sunnybrook’s Twins Clinic, Canada’s first and largest clinic dedicated to multiple (i.e., twin and triplet) pregnancies. He is a maternal-fetal medicine specialist, an obstetrician with additional training in high-risk pregnancies. He completed his fellowship in maternal-fetal medicine at the University of Toronto in 2014, after which he joined Sunnybrook. Over the years, he has looked after thousands of twin and triplet pregnancies, from the first ultrasound through to delivery.

Dr. Melamed also directs the Sunnybrook Twins Research Centre and holds the Waugh Family Chair in Twin Research at the University of Toronto, where he is a Professor of Obstetrics and Gynaecology. He has published more than 270 studies, most of them on twin pregnancies, fetal growth, and the placenta. Much of this research has changed how twins are cared for today. His work helped bring in growth charts made specifically for twins, clearer guidance on healthy weight gain, and better evidence on when and how twins should be delivered. He also led the international guidelines on fetal growth that doctors now use around the world. Many of the tools on this website came out of this research.

Much of what Dr. Melamed has learned in the clinic has gone into the information and tools on this website, which are meant to give families clear, reliable information about their own twin pregnancy. He places particular value on taking the time to explain the reasoning behind each recommendation and answer questions honestly, so that families can take part in the decisions about their care rather than simply receiving them.