We conducted a cross-sectional study among 194 pregnant women from two low-income settings in Cambodia. The inclusion period lasted from October 2015 through December 2017. Maternal serum samples were analyzed for persistent organic pollutants (POPs). The aim was to study potential effects on birth outcomes. We found low levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCP), except for heptachlors, β-hexachlorocyclohexane (HCH), heptachlor epoxide, and p,p’-DDE. There were few differences between the two study locations. However, the women from the poorest areas had significantly higher concentrations of p,p’-DDE (p < 0.001) and hexachlorobenzene (HCB) (p = 0.002). The maternal factors associated with exposure were parity, age, residential area, and educational level. Despite low maternal levels of polychlorinated biphenyls, we found significant negative associations between the PCB congeners 99 (95% CI: −2.51 to −0.07), 138 (95% CI: −1.28 to −0.32), and 153 (95% CI: −1.06 to −0.05) and gestational age. Further, there were significant negative associations between gestational age, birth length, and maternal levels of o,p’-DDE. Moreover, o,p’-DDD had positive associations with birth weight, and both p,p’-DDD and o,p’-DDE were positively associated with the baby’s ponderal index. The poorest population had higher exposure and less favorable outcomes.

We conducted an observational study of 194 pregnant women from two different study sites in rural Cambodia. Socioeconomic and anthropometric data was obtained from the women and their newborns. In addition, we collected blood and urine samples from the women for further analyses in planned papers. There were significant differences between the two study groups for clinical outcomes. The mothers from the poorer area were shorter and weighed less at the time of inclusion. Their babies had significantly smaller head circumferences and a lower ponderal index. Conclusion: There are significant anthropometric differences between women and their newborns from two separate study sites in Cambodia. Possible associations between stunting and exposure to Persistent Toxic Substances (PTS) as organochlorines and toxic trace elements will be investigated in future studies.

The results correspond to experiences from modern prehospital trauma systems: Basic Life Support reduces maternal and perinatal death if provided early. Trained TBAs are effective if well-integrated in maternal health programs. Houy C , Ha SO , Steinholt M , Skjerve E , Husum H . Delivery as trauma: a prospective time-cohort study of maternal and perinatal mortality in rural Cambodia. Prehosp Disaster Med. 2017;32(2):180-186.