Vol. 7, Issue 2, Part D (2025)

Air pollution, particularly nitrogen dioxide (NO₂), has been linked to adverse pregnancy outcomes, including low birth weight and complicated deliveries. COVID-19 pandemic has further highlighted environmental and health disparities, especially among pregnant women infected with SARS-CoV-2. Aim: to explore the impact of air pollution on birth weight and delivery way among women infected with SARS-CoV-2 during pregnancy. Methods: A cross-sectional study was conducted with 1,559 women, utilizing questionnaires, air quality data from Lithuanian Environmental Protection Agency, and statistical analyses including logistic regression. Participants’ residential NO₂ levels were classified into tertiles, and associations with birth weight and delivery outcomes were assessed, adjusting for confounders. Results: Higher NO₂ exposure was associated with a significant decrease in mean birth weight (from 3300 g to 3100 g) and increased odds of low birth weight (<2500 g) (adjusted OR=2.30, 95% CI: 1.35-3.92). Elevated NO₂ levels correlated with a spontaneous vaginal birth and a higher likelihood of emergency S/C during labour. Conclusions. Elevated NO₂ exposure during pregnancy is linked to adverse obstetric outcomes, including lower birth weight and increased intervention rates, particularly among women infected with SARS-CoV-2. These findings advocate for stringent air quality policies to enhance maternal, neonatal health, during public health emergencies.