Pregnancy in CTD‐interstitial lung disease: Current evidence, clinical challenges, and a proposed management algorithm

Pregnancy in women with connective tissue disease‐interstitial lung disease (CTD‐ILD) presents a complex and high‐risk clinical scenario involving maternal health, fetal outcomes, and emerging therapeutic challenges. Despite increasing recognition of CTD‐ILD among women of reproductive age, evidence guiding pregnancy management remains limited, particularly across different levels of disease severity, with persistent gaps in understanding maternal and fetal outcomes, optimal assessment strategies, and therapeutic approaches. The paucity of high‐quality, prospective data means that clinicians must often rely on limited observational evidence, navigating a landscape of clinical uncertainty and methodological limitations. This review summarizes current evidence and highlights key knowledge gaps, with a specific focus on preconception, antenatal, and postpartum care. It emphasizes the need for coordinated, multidisciplinary approaches and calls for dedicated research frameworks, such as registries and predictive models, to improve maternal and fetal health outcomes. These findings underscore the need for individualized, multidisciplinary care within an evolving evidence base.