Determinants of low birthweight among the Mendi of Sierra Leone: implications for medical and socio-economic strategies.

In order to identify the most appropriate interventions to reduce the amount of low birthweight among the Mendi people of Sierra Leone, the seasonal pattern of birthweights has been studied in three hospitals and compared with the incidence of known risk factors. Malaria and pregnancy-induced hypertension are shown to contribute to the excess low birthweight during the rainy season, particularly in primiparous women. There are no significant seasonal food shortages in this population and the best correlate for the bimodal seasonal excesses of low birthweight is the amount of agricultural work performed by the women during planting and harvesting. The significance of this for the choice of strategies to increase agricultural productivity is discussed.