Drugs in pregnancy: SSRIs late in gestation: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Drugs in pregnancy: SSRIs late in gestation

Sample item

A term neonate whose mother took an SSRI throughout pregnancy develops tachypnoea and cyanosis soon after birth. Echocardiography shows a structurally normal heart. Late-pregnancy SSRI exposure is associated with which neonatal condition?

ANeural tube defectBNeonatal thyrotoxicosisCPersistent pulmonary hypertension of the newbornDFetal hydantoin syndrome

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Persistent pulmonary hypertension of the newborn

Exposure to SSRIs after the 20th week of gestation is associated with a small increase in persistent pulmonary hypertension of the newborn, where the pulmonary vascular resistance stays high after birth. Neonates may also show transient irritability or poor feeding from discontinuation after delivery.

Option by option

A. Neural tube defect
Neural tube defects are linked to valproate and carbamazepine.
B. Neonatal thyrotoxicosis
Neonatal thyrotoxicosis arises from transplacental thyroid-stimulating antibodies in maternal Graves disease.
C. Persistent pulmonary hypertension of the newborn (correct)
Correct. Late-pregnancy SSRI exposure raises the risk of persistent pulmonary hypertension of the newborn.
D. Fetal hydantoin syndrome
Fetal hydantoin syndrome follows phenytoin exposure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Persistent pulmonary hypertension of the newborn. Exposure to SSRIs after the 20th week of gestation is associated with a small increase in persistent pulmonary hypertension of the newborn, where the pulmonary vascular resistance stays high after birth.

Why is "Neural tube defect" not the answer?

Neural tube defects are linked to valproate and carbamazepine.

Why is "Neonatal thyrotoxicosis" not the answer?

Neonatal thyrotoxicosis arises from transplacental thyroid-stimulating antibodies in maternal Graves disease.

Why is "Fetal hydantoin syndrome" not the answer?

Fetal hydantoin syndrome follows phenytoin exposure.

What concept does this question test?

It tests Drugs in pregnancy: SSRIs late in gestation in Pharmacology. Neonates may also show transient irritability or poor feeding from discontinuation after delivery.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Drugs in pregnancy: SSRIs late in gestation?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.