New EU-funded research shows that women who suffer from clinical depression and anxiety during pregnancy are more likely to give birth to smaller babies, who have a higher risk of dying in infancy. The findings were made by researchers at the Karolinska Institutet in Sweden and the Bangladesh Rural Advancement Committee (BRAC) after studying women in rural Bangladesh. They claim this is the first time such conclusions have been drawn from a non-Western population. EU support for the research, presented in the BMC Public Health journal, came from the EU Asia Link Programme with more than EUR 60,000. The scientists studied the mental health of 720 women in the third trimester of pregnancy from 2 rural sub-districts of Bangladesh for symptoms of antepartum depression and antepartum anxiety, and then followed them until 6 to 8 months postpartum. They found that mental health issues were likely to be a primary contributor to infant mortality and poor child health, above poverty, malnutrition or low socioeconomic status. In Bangladesh the estimated point prevalence of antepartum depression is as high as 33% and low birth weight (LBW) is estimated to stand at 36%. This means that every year more than 1 million babies are born with LBW in the country. 'Eighteen percent of the women ... were diagnosed as having depression and one quarter as having anxiety during pregnancy, and these women were much more likely to give birth to very small babies,' explained lead researcher Hashima-E Nasreen from BRAC, a national non-government development organisation that provides services for social and economic development. She insisted that 'this is a worrying problem, since low birth weight is strongly associated with infant death, which may in turn perpetuate the cycle of mental health problems and underdevelopment'. Dr Nasreen and her colleagues pointed out that LBW remains a major problem in low-income countries, affecting over 90% of the world's total number of infants, and is associated with increased risk of infant mortality and morbidity. They also highlighted that babies with a LBW suffer an increased risk of neurodevelopmental outcome, cardiovascular disease, diabetes, emotional problems, and psychotic illness in later life. However, they admitted that evidence linking maternal depressive and anxiety symptoms with infant LBW is conflicting with studies from Brazil, India and Pakistan, finding an association between antepartum mental disorders and LBW. On the other hand, studies from the China, Ethiopia, Sweden and the US have shown no significant association between LBW and maternal depressive symptoms. But the researchers insisted that the comparability of study results is complicated by the diversity of definitions, the measurement of prenatal maternal depressive symptoms, and the time points of assessment. This latest study was carried out as part of a prospective longitudinal study of perinatal depressive and anxiety symptoms among women in 2 subdistricts of the Mymensingh district, situated 120 kilometres (km) north of the capital city of Bangladesh, Dhaka. As is typical of rural Bangladesh, the economy is agrarian and approximately 50% of the population lives below the poverty level. The majority of women are involved in household work and childcare. The researchers said the study raised awareness of the significance of depression and anxiety leading to poor health in south Asian countries and suggested that one way to reach the internationally agreed United Nations (UN) Millennium Development Goal to reduce child mortality in the developing world would be to invest in mental health support services in this area.