Clinical depression and anxiety during pregnancy results in smaller babies that are more likely to die in infancy, according to new research published in the open access journal BMC Public Health. The study, which focused on women living in rural Bangladesh, provides the first finding of its kind in a non-Western population.

The research indicates that mental health issues are likely to be a primary contributor to infant mortality and poor child health, above poverty, malnutrition or low socio-economic status.

A collaboration between researchers at the Karolinska Instituet in Sweden and the Bangladesh Rural Advancement Committee (BRAC) assessed the mental health of 720 women in the third trimester of pregnancy from two rural sub-districts of Bangladesh for symptoms of antepartum depression (Edinburgh Postpartum Depression Scale) and antepartum anxiety (State Trait Anxiety Inventory) and followed them until 6-8 months postpartum.

Infant birth weight of 81% babies born at term was measured within 48 hours of delivery and baseline data provided socio-economic, anthropometric, reproductive, obstetric and social support information. Lead researcher Hashima-E- Nasreen explains, "18% of the women we studied in two rural areas of Bangladesh 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. 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."

The study raises awareness of the significance of depression and anxiety leading to poor health in South Asian countries. It suggests that one way to reach the internationally-agreed Millennium Development Goal to reduce child mortality in the developing world would be to invest in mental health support services in this area.