Patel & Prince (Reference Patel and Prince2006) reported cohort data from Goa, India that showed maternal psychological morbidity to be independently associated with low birth weight (<2.5 kg) and to have an adverse impact on foetal growth. We agree with the authors’ findings and consider that low birth weight as a consequence of treatable psychological morbidity during pregnancy should be an important health priority worldwide.

Recently we investigated whether exposure to the bombing of Belgrade in 1999 during pregnancy was associated with lower birth weight of babies. Mean birth weight of infants born in 1999 in Belgrade was compared with that of those born in 1996 and 2003 (no stressful events affected the city in these years). We collated data on the number of deliveries in Belgrade, birth weight, the percentage of stillborn babies, the percentage of premature births and maternal age from information on deliveries collected annually by the Institute of Public Health, Belgrade. Secondary analysis of this data-set, despite some methodological limitations, revealed that mother's age, percentage of stillborn babies and the percentage of premature births did not differ between the years but there was a significant decrease in mean birth weight of all babies born in 1999 compared with the other 2 years (3.111 kg v. 3.278 kg in 1996 and 3.223 kg in 2003) (P<0.05). Similarly, Lederman et al (Reference Lederman, Rauh and Weiss2004) showed that infants born at term to women who were pregnant on 11 September 2001, and who were living within a 2-mile radius of the World Trade Center (New York) during the month after the bombings, showed significant decreases in birth weight and height.

Infants of low birth weight who are born at term are more likely to experience psychological distress in adulthood (Reference Wiles, Peters and LeonWiles et al, 2005) and to have an increased risk of affective illness (Reference Gale and MartynGale & Martyn, 2004). Therefore not only is research on maternal psychological morbidity very important but a specific screening strategy and preventive plans for infants at risk of low birth weight are urgently needed worldwide.