PMH-C Anxiety Disorders in Pregnancy 3

Question 1

A pregnant woman with panic disorder asks about the risk of neonatal adaptation syndrome if she takes an SSRI. Which symptom cluster is most associated with this syndrome?

Accepted Answer

Jitteriness, poor feeding, and transient respiratory distress

Answer

Macrosomia, polycythemia, and hypoglycemia

Answer

Hyperbilirubinemia, thrombocytopenia, and seizures

Answer

Cleft palate, cardiac defects, and hypospadias

Question 2

Which anxiety disorder is most likely to have its onset triggered specifically by the physiological changes of early pregnancy?

Accepted Answer

Panic disorder

Answer

Specific phobia

Answer

Social anxiety disorder

Answer

Agoraphobia

Question 3

What is the primary mechanism by which prenatal maternal anxiety is thought to affect fetal neurodevelopment?

Accepted Answer

Glucocorticoid exposure altering fetal HPA axis programming

Answer

Direct placental transfer of anxiolytic medications

Answer

Reduced maternal appetite leading to nutritional deficits

Answer

Maternal hyperventilation causing fetal hypoxia

Question 4

A woman at 20 weeks gestation has a history of childhood sexual trauma and presents with hypervigilance, avoidance of prenatal exams, and flashbacks. The most appropriate trauma-informed approach is:

Accepted Answer

Coordinate care with a trauma-informed therapist and allow patient control during exams

Answer

Delay all pelvic exams until the postpartum period

Answer

Prescribe a benzodiazepine before every prenatal visit

Answer

Refer exclusively to a psychiatrist and stop OB care temporarily

Question 5

Which screening tool has been validated specifically to assess anxiety symptoms in the perinatal period and complements the Edinburgh Postnatal Depression Scale?

Accepted Answer

Perinatal Anxiety Screening Scale (PASS)

Answer

State-Trait Anxiety Inventory (STAI)

Answer

Penn State Worry Questionnaire

Answer

Social Phobia Inventory (SPIN)

Question 6

A clinician is considering buspirone for a pregnant patient with GAD who cannot tolerate SSRIs. What should the clinician know about buspirone in pregnancy?

Accepted Answer

Safety data in human pregnancy is limited and animal studies show some concern

Answer

It is FDA Pregnancy Category A with extensive safety data

Answer

It is absolutely contraindicated due to confirmed teratogenicity

Answer

It is the preferred second-line agent per all major perinatal guidelines

Question 7

When educating a pregnant patient about the risks of untreated versus treated anxiety, which statement is most accurate?

Accepted Answer

Untreated severe anxiety carries its own fetal and maternal risks that must be weighed against treatment risks

Answer

All pharmacological treatments pose greater risk than untreated anxiety

Answer

Psychotherapy is risk-free and always sufficient to treat perinatal anxiety

Answer

Anxiety is benign in pregnancy and does not require treatment