{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:08:41Z","timestamp":1784642921520,"version":"3.55.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010804","name":"Faculty of Medicine, Prince of Songkla University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec007\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Given the growing evidence linking increased abdominal adiposity in early pregnancy to a higher risk of developing gestational diabetes mellitus (GDM), this study aims to evaluate the reliability of the sonographic measurements of abdominal adiposity during the first trimester of pregnancy, comparing the performance of sonographers with varying levels of experience.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec008\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cross-sectional study was conducted on singleton Asian pregnant women with gestational ages between 11 and 14 weeks. Transabdominal ultrasound measurements of abdominal adiposity were performed by three sonographers with different experience levels, including measurements of subcutaneous fat thickness (SFT), visceral fat thickness (VFT), and preperitoneal fat thickness (PFT) using three techniques. Intra- and interobserver reliability were assessed using intraclass correlation coefficient (ICC) with a 95% confidence interval. Spearman pairwise correlation coefficients were used to analyze the correlation between maternal body composition and the sonographic measurements of abdominal adiposity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec009\">\n<jats:title>Result<\/jats:title>\n<jats:p>Ninety pregnant women participated. The overall ICCs indicated excellent intraobserver reliability for all parameters, with VFT measurement showing slightly lower reliability for less experienced operators. Interobserver reliability was excellent for all measurements except VFT, which showed good reliability between the most and least experienced operators. VFT correlated significantly with maternal waist-to-hip ratio (WHR).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec010\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Sonographic measurements of abdominal adiposity during the first trimester show high reliability, particularly when performed by experienced sonographers. Notably, VFT measurement displayed a significant positive correlation with maternal WHR, highlighting its potential as an indicator of central adiposity.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0326949","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T17:41:23Z","timestamp":1750959683000},"page":"e0326949","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing the reliability of abdominal adiposity measurements by transabdominal ultrasound in first trimester pregnancies with sonographers of varying experience levels"],"prefix":"10.1371","volume":"20","author":[{"given":"Noppasin","family":"Khwankaew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nattraporn","family":"Srisovanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0234-0274","authenticated-orcid":true,"given":"Ninlapa","family":"Pruksanusak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"pone.0326949.ref001","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1055\/s-0028-1110084","article-title":"The impact of maternal obesity on the incidence of adverse pregnancy outcomes in high-risk term pregnancies","volume":"26","author":"S Joy","year":"2009","journal-title":"Am J Perinatol"},{"issue":"2","key":"pone.0326949.ref002","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s13224-019-01301-8","article-title":"Maternal obesity and pregnancy outcome: in perspective of new Asian Indian guidelines","volume":"70","author":"I Kutchi","year":"2020","journal-title":"J Obstet Gynaecol India"},{"key":"pone.0326949.ref003","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0140-6736(03)15268-3","article-title":"Appropriate body-mass index for Asian populations and its implication for policy and intervention strategies","volume":"363","author":"WHO Expert Consultation","year":"2004","journal-title":"Lancet"},{"key":"pone.0326949.ref004","author":"Centers for Disease Control and Prevention","year":"2024"},{"issue":"9","key":"pone.0326949.ref005","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.3390\/healthcare11091315","article-title":"Trends in the prevalence of diabetes mellitus in pregnancy during the past two decades in Northern Thailand","volume":"11","author":"P Jatavan","year":"2023","journal-title":"Healthcare (Basel)"},{"issue":"5","key":"pone.0326949.ref006","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.3390\/ijerph19052583","article-title":"Prevalence and risk factors of gestational diabetes mellitus in bangladesh: findings from demographic health survey 2017-2018","volume":"19","author":"T Mazumder","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"pone.0326949.ref007","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.whi.2010.06.003","article-title":"Racial\/ethnic disparities in gestational diabetes mellitus: findings from a population-based survey","volume":"20","author":"M Hunsberger","year":"2010","journal-title":"Womens Health Issues"},{"issue":"6428","key":"pone.0326949.ref008","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1136\/bmj.288.6428.1401","article-title":"Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913","volume":"288","author":"B Larsson","year":"1984","journal-title":"Br Med J (Clin Res Ed)"},{"issue":"5","key":"pone.0326949.ref009","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1038\/ijo.2010.5","article-title":"Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis","volume":"34","author":"DO Okorodudu","year":"2010","journal-title":"Int J Obes (Lond)"},{"issue":"6454","key":"pone.0326949.ref010","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1136\/bmj.289.6454.1257","article-title":"Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden","volume":"289","author":"L Lapidus","year":"1984","journal-title":"Br Med J (Clin Res Ed)"},{"issue":"6","key":"pone.0326949.ref011","doi-asserted-by":"crossref","first-page":"722","DOI":"10.29271\/jcpsp.2022.06.722","article-title":"The value of first-trimester maternal abdominal visceral adipose tissue thickness in predicting the subsequent development of gestational diabetes mellitus","volume":"32","author":"S Tunc","year":"2022","journal-title":"J Coll Physicians Surg Pak"},{"key":"pone.0326949.ref012","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.ejogrb.2018.07.001","article-title":"Body fat index: a novel alternative to body mass index for prediction of gestational diabetes and hypertensive disorders in pregnancy","volume":"228","author":"AA Nassr","year":"2018","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"11","key":"pone.0326949.ref013","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1080\/14767058.2020.1781808","article-title":"Ultrasound evaluation of subcutaneous and visceral abdominal fat as a predictor of gestational diabetes mellitus: a systematic review","volume":"35","author":"FT Benevides","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"7","key":"pone.0326949.ref014","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.jogc.2017.09.026","article-title":"First-trimester abdominal adipose tissue thickness to predict gestational diabetes","volume":"40","author":"M Bourdages","year":"2018","journal-title":"J Obstet Gynaecol Can"},{"issue":"2","key":"pone.0326949.ref015","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/aogs.13486","article-title":"Increased maternal abdominal subcutaneous fat thickness and body mass index are associated with increased cesarean delivery: a prospective cohort study","volume":"98","author":"V Eley","year":"2019","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"2","key":"pone.0326949.ref016","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/1471-0528.13758","article-title":"Maternal abdominal subcutaneous fat thickness as a predictor for adverse pregnancy outcome: a longitudinal cohort study","volume":"123","author":"NJ Kennedy","year":"2016","journal-title":"BJOG"},{"issue":"2","key":"pone.0326949.ref017","doi-asserted-by":"crossref","first-page":"493","DOI":"10.3390\/jcm13020493","article-title":"Maternal visceral fat in prediction of gestational diabetes mellitus","volume":"13","author":"J Detsrisuwan","year":"2024","journal-title":"J Clin Med"},{"issue":"8","key":"pone.0326949.ref018","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0271068","article-title":"Association of body composition in early pregnancy with gestational diabetes mellitus: a meta-analysis","volume":"17","author":"FA Rahnemaei","year":"2022","journal-title":"PLoS One"},{"key":"pone.0326949.ref019","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1111\/dme.13906","article-title":"Clinical utility of ultrasonography-measured visceral adipose tissue depth as a tool in early pregnancy screening for gestational diabetes: a proof-of-concept study","volume":"36","author":"PK Thaware","year":"2019","journal-title":"Diabet Med"},{"issue":"1","key":"pone.0326949.ref020","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1038\/s41598-020-59065-5","article-title":"Visceral adipose tissue depth in early pregnancy and gestational diabetes mellitus - a cohort study","volume":"10","author":"JG Alves","year":"2020","journal-title":"Sci Rep"},{"issue":"9","key":"pone.0326949.ref021","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/j.acra.2011.04.014","article-title":"Accuracy, reproducibility and repeatability of ultrasonography in the assessment of abdominal adiposity","volume":"18","author":"A Bazzocchi","year":"2011","journal-title":"Acad Radiol"},{"issue":"1","key":"pone.0326949.ref022","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1038\/ejcn.2009.68","article-title":"Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk--a review of the literature","volume":"64","author":"R Huxley","year":"2010","journal-title":"Eur J Clin Nutr"},{"issue":"5","key":"pone.0326949.ref023","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.3390\/biomedicines11051492","article-title":"Evaluating the adipose tissue depth as a predictor factor for gestational diabetes in later pregnancy-a systematic review","volume":"11","author":"B-M Salmen","year":"2023","journal-title":"Biomedicines"},{"issue":"4","key":"pone.0326949.ref024","article-title":"Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery - a cohort study","volume":"15","author":"A da S Rocha","year":"2020","journal-title":"PLoS One"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0326949","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T17:41:40Z","timestamp":1750959700000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0326949"}},"subtitle":[],"editor":[{"given":"Athanasios G.","family":"Pantelis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":24,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0326949","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]}}}