{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:42:18Z","timestamp":1793796138839,"version":"4.6.1"},"reference-count":57,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chiang Mai University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Air pollution exposure has been increasingly linked to adverse pregnancy outcomes. This study aimed to investigate the effects of PM2.5 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. PM2.5 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 PM2.5 exposure and pregnancy outcomes. PM2.5 exposure at levels exceeding 37.5 \u03bcg\/m3 throughout pregnancy significantly increased the risk of preterm birth (aOR = 2.19, p &lt; 0.001) and LBW (aOR = 1.99, p &lt; 0.001) compared to the reference group (15.1\u201337.5 \u03bcg\/m3). However, exposure at levels \u226415.0 \u03bcg\/m3 also increased the risk for both outcomes compared to the same reference group. Subgroup analysis of high-risk pregnant women, including women aged &gt; 35 years, with pre-pregnancy BMI (&lt;18.5), pregnancy-induced hypertension, and nulliparous women, showed that the range of the critical PM2.5 exposure threshold was 32.3\u201338.4 \u03bcg\/m3 for preterm birth and 31.2\u201338.2 \u03bcg\/m3 for LBW. This study highlights the significant association between PM2.5 exposure and adverse pregnancy outcomes and suggests the need for targeted interventions to mitigate its effects on maternal and child health.<\/jats:p>","DOI":"10.3390\/toxics13040304","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T04:42:07Z","timestamp":1744605727000},"page":"304","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association of Maternal PM2.5 Exposure with Preterm Birth and Low Birth Weight: A Large-Scale Cohort Study in Northern Thailand (2016\u20132022)"],"prefix":"10.3390","volume":"13","author":[{"given":"Pak","family":"Thaichana","sequence":"first","affiliation":[{"name":"Office of Research Administration, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8337-9524","authenticated-orcid":false,"given":"Patumrat","family":"Sripan","sequence":"additional","affiliation":[{"name":"Research Center for Infectious Disease and Substance Use, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaraporn","family":"Rerkasem","sequence":"additional","affiliation":[{"name":"Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Research Center for Infectious Disease and Substance Use, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3389-6478","authenticated-orcid":false,"given":"Theera","family":"Tongsong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraphan","family":"Sangsawang","sequence":"additional","affiliation":[{"name":"Regional Health Promotion Center1 Hospital, Chiang Mai 50100, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1488-5105","authenticated-orcid":false,"given":"Sawaeng","family":"Kawichai","sequence":"additional","affiliation":[{"name":"Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Worawut","family":"Srisukkham","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanane","family":"Wanapirak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirinart","family":"Sirilert","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natnita","family":"Mattawanon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chotiros","family":"Phanpong","sequence":"additional","affiliation":[{"name":"Regional Health Promotion Center1 Hospital, Chiang Mai 50100, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2766-7046","authenticated-orcid":false,"given":"Krongporn","family":"Ongprasert","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1226-1956","authenticated-orcid":false,"given":"Jos\u00e9 G. B.","family":"Derraik","sequence":"additional","affiliation":[{"name":"Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Pediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1010, New Zealand"},{"name":"Department of Women\u2019s and Children\u2019s Health, Uppsala University, 753 10 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittipan","family":"Rerkasem","sequence":"additional","affiliation":[{"name":"Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e308","DOI":"10.1097\/EE9.0000000000000308","article-title":"A cohort study of the multipollutant effects of PM2.5, NO2, and O3 on C-reactive protein levels during pregnancy","volume":"8","author":"Gogna","year":"2024","journal-title":"Environ. 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