Singer Jesy Nelson recently shared an emotional update regarding the complications she is experiencing in her pregnancy with twin babies. Former Little Mix singer Jesy, who is having twins with partner Zion Foster, announced that she has been diagnosed with pre-twin-to-twin transfusion syndrome (pre-TTTS). The condition, which is present in pregnancies involving twins with a shared placenta, has serious risks involved and needs intense medical supervision. As Nelson embarks on this difficult journey, her story enlightens us about a rare but dangerous condition many expectant parents may not know much about.

Twin-to-twin transfusion syndrome is a rare but dangerous condition that arises in monochorionic twin pregnancies, in which identical twins share a single placenta. The placenta supplies the developing babies with oxygen, nutrients, and blood flow, but in TTTS, there is an imbalance of blood vessels that interconnect the twins, and thus the vital resources are not evenly distributed. One twin, or the donor twin, shares excess blood with the other, referred to as the recipient twin. This leads to one baby becoming malnourished and possibly anemic, and the other in danger of heart problems due to too much blood.

Nelson described her diagnosis in a heartfelt Instagram video, explaining that she is currently in the pre-stage of TTTS and undergoing frequent monitoring. "I am being scanned twice a week, and each time, things have gotten a little worse," she shared, expressing her fears and hopes for the health of her babies.

Potential Risks of TTTS

If left untreated, TTTS can have devastating consequences. Medical research indicates that:

• 90% of the cases of untreated TTTS lead to loss of one or both twins.
• Despite treatment, only a 70% survival rate for both twins is assured.
• Severe forms can result in preterm labor, cardiac failure in the recipient twin, and organ failure in the donor twin.
• Complications in long-term survivors include neurological damage and developmental delay in surviving infants.

TTTS usually advances in stages, beginning with minimal changes in fluid levels and worsening as one twin continues to get an unequal share of blood. In extreme cases, fetal laser surgery, referred to as the Solomon technique, can be employed to divide the blood vessels and balance the twins.

Why Identical Twin Pregnancies Are More Complicated

Identical twins may develop differently, and their own unique form of placental sharing can have a dramatic effect on pregnancy risk. Jesy Nelson's twins are considered monochorionic diamniotic (mono/di), which means they share a placenta but have two amniotic sacs. This is the type of pregnancy in about 70% of identical twin pregnancies and carries an increased risk of complications like TTTS, umbilical cord entanglement, and growth restriction.

Conversely, dichorionic diamniotic (di/di) twins both have a separate placenta and amniotic sac, which greatly diminishes the threat of TTTS. Twin pregnancy type is normally identified by early ultrasound, with physicians being able to track future complications from inception.

Other Twin Pregnancy Health Risks

Twin pregnancies, even without the presence of TTTS, entail a variety of health risks to the mother as well as infants:

1. Premature Birth

Over 60% of twin pregnancies end in premature delivery, with birth usually taking place before 37 weeks. Premature infants can have immature organs and need neonatal intensive care (NICU) assistance to assist with breathing, feeding, and infection fighting.

2. Gestational Hypertension and Preeclampsia

Pregnant women with multiples are at increased risk of having high blood pressure during pregnancy. This, if left untreated, can result in preeclampsia, a serious complication of pregnancy that can result in damage to organs, preterm labor, and in some cases, maternal or fetal death.

3. Anemia

Pregnant women carrying multiples are twice as likely to experience anemia, a condition where the body does not produce enough healthy red blood cells. This can lead to fatigue, dizziness, and complications during delivery.

4. Birth Defects

According to John Hopkins Medicine, multiple birth babies are twice as likely to have congenital abnormalities compared to single births. These can include heart defects, neural tube defects, and gastrointestinal issues.

5. Amniotic Fluid Imbalances

When twins have to share a placenta, they are more likely to have polyhydramnios (excess amniotic fluid) or oligohydramnios (not enough amniotic fluid). Both result in distress to the babies during fetal development and can result in premature labor.

6. Postpartum Hemorrhage

Twins are at increased risk of excessive postpartum hemorrhage because their uterus is larger and there are greater blood supply needs.

Jesy Nelson's openness about her challenging experience is raising awareness for TTTS, a condition that few individuals—let alone expectant mothers and fathers—might be aware of. Through her tearful video, Nelson stressed the significance of knowing about twin pregnancies aside from the thrill of having multiples. "We had no idea that this type of thing occurs when you're having twins. We just desperately want to make people aware of this because there are so many people who aren't aware."

Her case reminds us of the intricacies involved in twin pregnancy and the significance of early identification and medical management. For mothers carrying twins, frequent ultrasounds and vigilance can become a life-and-death issue for early detection and better outcomes of both babies.

Through constant medical attention and care, she and her partner Zion Foster remain positive and get ready for their babies to be born. In other parents whose situations are no different, the story of Nelson highlights awareness, medical progress, and emotional encouragement in handling complicated pregnancies.

The expecting parents of twin siblings are advised to discuss TTTS screening and possible interventions with their physicians to give their babies the best chance.

Delhi continues to battle high PM2.5 levels, even as a new study estimates that meeting the World Health Organization's (WHO) air quality guidelines could prevent or postpone 9.4 million deaths annually across 136 low- and middle-income countries (LMICs).

Following Diwali celebrations on November 8, PM2.5 concentrations in several parts of the capital reportedly exceeded 66 times the WHO's recommended 24-hour guideline. By November 11, Delhi's AQI had improved to below 300, in the 'poor' category, after several days in the 'very poor' and 'severe' categories.

Led by University of Cambridge researchers, the modelling study also found that cleaner air could reduce disease burden, healthcare costs and productivity losses.

What Did The Study Find?

Published in Environment International, the study assessed the health and economic benefits of reducing PM₂.₅ and nitrogen dioxide (NO₂) levels across 136 LMICs.

Researchers used pollution, population and health data to model the impact of meeting WHO air quality guidelines and interim targets.

The findings suggest that meeting WHO guidelines could:

• Prevent or postpone 9.4 million deaths annually linked to PM₂.₅
• Prevent or postpone 1.1 million deaths linked to NO₂
• Reduce deaths associated with PM₂.₅ by an estimated 6.6 million and those associated with NO₂ by 435,000, even under less stringent interim targets

Meeting PM₂.₅ guidelines could also mean fewer new cases of:

• COPD: 2.8 million
• Dementia: 1.1 million
• Coronary heart disease: 7.3 million
• Stroke: 2.3 million

Cleaner Air Could Save Billions

The researchers also estimated substantial economic benefits from meeting PM₂.₅ guidelines.

Annual direct medical cost savings could include:

• $11.8 billion for coronary heart disease
• $5.9 billion for stroke
• $8.6 billion for dementia

Productivity gains could reach $17.9 billion for stroke, $18.1 billion for COPD and $5.3 billion for coronary heart disease annually.

"Meeting the WHO's air quality guideline values will not be straightforward, but low- and middle-income countries have a critical opportunity to shape healthier futures as their populations grow and their cities expand," said Dr Haneen Khreis of IMS Epidemiology at Cambridge.

She called for better decisions on transport, urban planning and energy, saying these could significantly improve air quality and reduce pollution-related diseases.

What Causes PM2.5 And NO₂ Pollution?

Outdoor air pollution is a major environmental health risk, linked to respiratory and cardiovascular diseases, including asthma, COPD, heart disease and stroke, as well as dementia.

In 2021, the WHO revised its air quality guidelines, setting recommended limits for pollutants including PM₂.₅ and NO₂.

PM₂.₅ consists of particles measuring 2.5 micrometers or smaller. They can travel deep into the lungs. Major sources include vehicle exhaust, power plants, industrial emissions and construction dust. These particles can also form through chemical reactions in the atmosphere.

NO₂ is mainly produced by burning fossil fuels. Sources include vehicle exhaust, industrial emissions and gas stoves and heaters.

Air pollution is a particularly serious challenge in LMICs, where rapid urbanisation, economic development and increasing vehicle use have contributed to poor air quality.

Policymakers attending the 31st Conference of the Parties (COP31) in Türkiye must put health at the centre of every climate negotiation, Professor Marina Romanello, Executive Director of the Lancet Countdown, told HealthandMe in an exclusive interview.

Marina, who led the 2026 Lancet Countdown on Health and Climate Change report released ahead of COP31, outlined the growing health consequences of global warming and the urgent need for stronger climate action.

Drawing on findings from the report, Marina warned that climate inaction is putting lives, livelihoods and public health at risk.

The report noted that climate commitments made since the Paris Agreement have delivered measurable health benefits, but progress remains too slow and uneven.

“One of the things that we are calling for negotiators to realise is that when they go to COP, they're not just negotiating budgets or carbon emissions or degrees of heating. What they're negotiating is people's health,” Marina told HealthandMe.

“They're negotiating how many people die from climate change. They're negotiating how many of our children will grow in these dangerous environments and have less of a chance in life.”

She stressed the need to recognise that climate change is not just an environmental issue.

“It's important to be very clear that climate change is not just a problem of the inanimate world or even of nature and polar bears. It's a problem of people here and today, and that our failure to act is costing people's lives, livelihood and health.”

Health Must Be Included Across All COP Negotiations

Also read: Climate Change Is Already Harming Health: WHO Chief Pushes Antalya Initiative At COP31

Marina, who is also a researcher at University College London's Institute for Global Health, urged policymakers to integrate health into all COP31 discussions rather than confining it to side events.

“We're also calling for countries not just to have climate change as one of the action agenda items and side events, but to actually consider climate change throughout their whole negotiations. Every negotiation stream needs to have health considerations so that we are aware of the hazards and the dangers that we're dealing with here.”

Countries Must Go Beyond COP Commitments

Read More: COP31 Begins On Health Day: How Will Countries Measure The Health Impact Of Climate Change?

Marina described COP as “a baseline” and “a starting point”, stressing that countries could go much further than the commitments agreed at the conference.

She cited India as an example of a country that stands to gain significantly from accelerating its climate transition, pointing to its natural resources, technological capabilities and opportunities to improve public health.

“In a country like India, where you have so many natural resources, where you have such impressive technology development, where you have so many opportunities from healthier air, improving access to energy, improving the transition towards more resilient, sustainable food systems, you are standing to win so massively from an accelerated transition at a country level.”

Marina also pointed out that countries rarely account for the health implications of their mitigation and adaptation plans. These include both potential negative impacts and the significant health benefits that stronger climate action could deliver.

Taking these benefits into account, she told HealthandMe, that it could increase the overall return on investment and make climate action more cost-effective.

Three Policy Interventions Governments Must Prioritise

READ: Climate Crisis Is A Health Crisis: Just 6 Actions Could Save 1.6 Million Lives, Says WHO

Marina outlined three key areas for government action at COP31:

1. Phase Out Fossil Fuels

Governments must prioritise phasing out fossil fuel use, particularly in urban centres where people live, she said.

“That will reduce the burden of air pollution and will mean that people have much less burden of chronic conditions and much less exacerbation of those conditions that they already have.”

2. Strengthen Healthcare Systems

Marina called for health systems to be equipped to respond to climate hazards and for healthcare professionals to receive training on climate change and health.

“They should know how to recommend better care and better preventative measures to their patients.”

3. Accelerate Emissions Reductions

Marina stressed that reducing greenhouse gas emissions must remain a priority for every country.

“We absolutely need to stop our emissions, our greenhouse gas emissions. Every country needs to pursue efforts to reduce their greenhouse gas emissions. It's a global health imperative.”

She added: “Reducing our greenhouse gas emissions in line with the Paris Agreement, redoubling efforts to mitigate climate change is a health imperative.”

Ozempic and Wegovy, whose active ingredient is semaglutide, have transformed the treatment of type 2 diabetes and obesity. These medications have also been linked to improved fertility in some cases. However, GLP-1 medications are not recommended during pregnancy.

Now, a study in pregnant sheep has found that semaglutide significantly reduced blood flow to the uterus and oxygen levels in developing fetuses.

Led by researchers at Adelaide University, the animal study raises questions about the potential effects of these medications on fetal development.

While the findings are preliminary and have not been established in humans, they highlight the need to understand the risks of exposure during pregnancy, particularly among women who may conceive unexpectedly or continue treatment before realising they are pregnant.

Semaglutide Reduced Blood Flow Within Two Hours

Also read: Woman Says GLP-1 Drug Helped Her Conceive

Adelaide University researcher Dr Mitchell Lock noted that although weight-loss medications have become incredibly popular, there's still a lot we don't know about how they might affect a developing baby.

With the new study, they aimed to better understand the potential effects of GLP-1 drugs during pregnancy so women and health care professionals can make informed and safe decisions about their use.

In the study, the researchers used magnetic resonance imaging (MRI) to assess maternal heart function and uterine blood flow before and after administering semaglutide to pregnant sheep. They also collected fetal blood samples and monitored blood pressure and heart rate to evaluate the drug's immediate effects.

The findings, published as a conference abstract in the journal Heart, Lung and Circulation, showed that semaglutide affected the mother's cardiovascular system and the supply of blood and oxygen to the developing fetus.

"Within two hours of administering semaglutide, we found that the amount of blood pumped by the mother's heart had significantly decreased, reducing blood flow to the uterus and lowering oxygen levels in the developing fetus," Lock said.

"Oxygen is essential for healthy fetal growth and development, so any reduction in its supply raises questions about what might happen if exposure to the drug continues throughout pregnancy."

Long-Term Effects On Fetal Development Remain Unclear

Read More: GLP-1 Drugs Ozempic, Zepbound Use Rises 24-Fold Among American Women After Childbirth

Senior researcher Janna Morrison said the findings highlight the need for further research into the potential effects of prolonged semaglutide exposure during pregnancy.

"Our findings suggest a potential risk to fetal development, but we haven't yet established whether these short-term changes affect fetal growth, what happens over a longer period of semaglutide use or whether similar effects could occur in human pregnancies," Morrison said.

Can GLP-1 Drugs Be Used During Pregnancy?

READ: GLP-1 Weight-Loss Drugs May Improve Fertility In Men With Obesity, Study Suggests

GLP-1 medications are not recommended for weight loss during pregnancy. Women planning to conceive should consult their healthcare professionals about discontinuing treatment.

For semaglutide, prescribing guidance recommends stopping the medication at least two months before a planned pregnancy.

Women who become pregnant while taking the medication should seek medical advice. Those who are breastfeeding should also discuss its use with their healthcare professional.

The American College of Obstetricians and Gynecologists advises against weight-loss medications during pregnancy. Women considering GLP-1 treatment should discuss its risks, benefits and timing with their healthcare professionals, particularly if they are planning to conceive.