At least 13 women have been found in a search and rescue operation and several of them are said to have been pregnant.
22 people have been rescued, according to Italy's Coast Guard, which fears many more have been killed. Among those currently missing are at least eight children and additional pregnant women.
Most of the people on board came from Tunisia and countries in West Africa, according to the UNHCR. One of the survivors tells Reuters that she lost her sister and an eight-month-old niece.
The alarm that the boat was in trouble came late on Sunday. The accident happened around six nautical miles off the coast of Lampedusa, according to the Coast Guard. The island is located south of Sicily and is a common destination for migrant boats coming from North Africa.