Air pollution exposure has been increasingly linked to adverse pregnancy outcomes. This study aimed to investigate the effects of PM_2.5 exposure throughout pregnancy on preterm birth, low birth weight (LBW), and small for gestational age (SGA). We analyzed a cohort of 16,965 pregnant women living in northern Thailand between 2016 and 2022. PM_2.5 concentration data were collected from two air quality monitoring stations operated by the Pollution Control Department (PCD) of Thailand. Logistic regression models were used to assess the association between daily PM_2.5 exposure and pregnancy outcomes. PM_2.5 exposure at levels exceeding 37.5 μg/m³ throughout pregnancy significantly increased the risk of preterm birth (aOR = 2.19, p < 0.001) and LBW (aOR = 1.99, p < 0.001) compared to the reference group (15.1–37.5 μg/m³). However, exposure at levels ≤15.0 μg/m³ also increased the risk for both outcomes compared to the same reference group. Subgroup analysis of high-risk pregnant women, including women aged > 35 years, with pre-pregnancy BMI (<18.5), pregnancy-induced hypertension, and nulliparous women, showed that the range of the critical PM_2.5 exposure threshold was 32.3–38.4 μg/m³ for preterm birth and 31.2–38.2 μg/m³ for LBW. This study highlights the significant association between PM_2.5 exposure and adverse pregnancy outcomes and suggests the need for targeted interventions to mitigate its effects on maternal and child health.

Antibiotic resistance (AR) associated with chronic limb-threatening ischemia (CLTI) poses additional challenges for the management of ischemic leg ulcers, increasing the likelihood of severe outcomes. This study assessed AR prevalence in bacteria isolated from CLTI-associated leg ulcers before (1 January 2017–10 March 2020; n = 69) and during (11 March 2020–31 December 2022; n = 59) the COVID-19 pandemic from patients admitted with positive wound cultures to a regional hospital in Chiang Mai (Thailand). There was a marked reduction in AR rates from 78% pre-pandemic to 42% during the pandemic (p < 0.0001), with rates of polymicrobial infections 22 percentage points lower (from 61% to 39%, respectively; p = 0.014). There were reduced AR rates to amoxicillin/clavulanate (from 42% to 4%; p < 0.0001) and ampicillin (from 16% to 2%; p = 0.017), as well as multidrug resistance (19% to 8%; p = 0.026). Factors associated with increased AR odds were polymicrobial infections (adjusted odds ratio (aOR) 5.6 (95% CI 2.1, 15.0); p = 0.001), gram-negative bacteria (aOR 7.0 (95% CI 2.4, 20.5); p < 0.001), and prior use of antibiotics (aOR 11.9 (95% CI 1.1, 128.2); p = 0.041). Improvements in infection control measures and hygiene practices in the community during the pandemic were likely key factors contributing to lower AR rates. Thus, strategic public health interventions, including community education on hygiene and the informed use of antibiotics, may be crucial in mitigating the challenges posed by AR in CLTI. Further, advocating for more judicious use of empirical antibiotics in clinical settings can balance effective treatment against AR development, thereby improving patient outcomes.

Background: Iron deficiency anemia is a recognized pregnancy risk, but excessive iron may also have adverse effects. Few studies, particularly in Asian populations, have examined elevated maternal ferritin in relation to birth outcomes. Objectives: To investigate the dose–response relationships between maternal serum ferritin concentrations in late pregnancy and birth outcomes, including preterm birth, small for gestational age (SGA), and placental characteristics. Methods: A retrospective study of 362 mother–infant pairs were analyzed. Maternal serum ferritin levels measured at 30–34 weeks’ gestation were divided into quintiles, using 30.1–43.0 µg/L as the reference. Logistic and linear regression models were applied to examine associations with preterm birth, SGA, and placental indices. Results: Preterm birth rates ranged 7.3–18.8% across ferritin quintiles, but no significant association was observed. In contrast, SGA prevalence increased from 20.8% to 47.2% (p-trend = 0.001). Women in the highest ferritin quintile had 3.31-fold higher adjusted odds of SGA (95% CI: 1.51–7.28, p = 0.003). Each SD increase in ferritin corresponded to 31% higher odds of SGA (OR = 1.31, 95% CI: 1.01–1.71). Elevated ferritin (>43.0 µg/L) was also associated with reduced placental weight (<415 g) (adjusted OR = 3.02, 95% CI: 1.61–5.69, p = 0.001). Conclusions: Increasing maternal ferritin levels in the third trimester were associated with a dose-dependent rise in SGA risk and reduced placental weight. These findings suggest that excessive iron status may adversely influence placental function and fetal growth, underscoring the need for individualized nutrition management during pregnancy.