Lifestyle intervention to improve outcomes in dichorionic twin pregnancies: study protocol for a multicentre randomised controlled trial with an integrated pilot study - the LIFETWIN trial

Introduction: Preterm birth and small-for-gestational-age (SGA) infants remain major contributors to neonatal morbidity, mortality and healthcare costs. Twin pregnancies account for a disproportionate share of these adverse outcomes, representing 18%–24% of all preterm births in Europe. Despite this high-risk profile, effective preventive strategies for twin pregnancies remain limited and mainly target cervical length. Emerging evidence suggests that maternal lifestyle factors, including diet, physical activity and stress management, may prolong gestational age and improve fetal growth.