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Related Experiment Video

Updated: Dec 13, 2025

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas
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Thyroid Function Test Abnormalities in Twin Pregnancies.

Zhirou Chen1, Xi Yang1, Chen Zhang1,2,3

  • 1Department of Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Thyroid : Official Journal of the American Thyroid Association
|August 5, 2020
PubMed
Summary

Twin pregnancies show altered thyroid function compared to singletons, with higher risks of hyperthyroidism early on and hypothyroidism later. These findings highlight the importance of monitoring thyroid health in twin gestations.

Keywords:
TSHdysfunctionfT4thyroidtwin pregnancy

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Area of Science:

  • Endocrinology
  • Maternal-Fetal Medicine
  • Reproductive Health

Background:

  • Twin pregnancies have increased thyroid hormone demands due to higher human chorionic gonadotropin (hCG) levels.
  • Quantification of thyroid function changes and abnormalities in twin pregnancies remains limited.

Purpose of the Study:

  • To evaluate and compare thyroid function and thyroid function test abnormalities in twin pregnancies versus singleton pregnancies.
  • To assess these differences during both early and late stages of gestation.

Main Methods:

  • Retrospective analysis of thyroid function tests from 1208 twin and 46,834 singleton pregnancies.
  • Thyroid function abnormalities were identified using population-based reference ranges.
  • Analyses were adjusted for maternal age and body mass index.

Main Results:

  • Early pregnancy: Twin pregnancies showed lower thyrotropin (TSH) and higher free thyroxine (fT4), with increased risks of hyperthyroidism and isolated hypothyroxinemia.
  • Late pregnancy: Twin pregnancies exhibited higher TSH, with increased risks of subclinical hypothyroidism, isolated hypothyroxinemia, and subclinical hyperthyroidism.
  • Significant differences in thyroid function tests and abnormality risks were observed between twin and singleton pregnancies in both early and late gestation.

Conclusions:

  • Twin pregnancies are associated with distinct thyroid function patterns, including increased risks of hyperthyroidism and hypothyroxinemia in early gestation.
  • In late gestation, twin pregnancies show a higher risk of hypothyroidism and persistently elevated risks of hypothyroxinemia and subclinical hyperthyroidism.
  • These findings underscore the need for careful thyroid monitoring throughout twin pregnancies.