Pregnancy in women with myelodysplastic syndromes: a scoping review of maternal, obstetric, and neonatal outcomes

Myelodysplastic syndromes (MDS) are rare in women of reproductive age, and evidence regarding pregnancy outcomes remains limited. A systematic literature search identified 21 publications reporting MDS recognized before or during pregnancy, encompassing 69 pregnancies. The data were descriptively analyzed and stratified by timing of MDS diagnosis. Of the 69 pregnancies, 52% involved women diagnosed with MDS before conception, while 48% were diagnosed during pregnancy. Leukemic transformation occurred exclusively among cases diagnosed during pregnancy. The majority of pregnancies resulted in live births, with rates exceeding 93% in both groups, and neonatal complications being uncommon. MDS diagnosed during pregnancy appears to confer higher maternal risk, underscoring the need for early recognition and multidisciplinary management. This scoping review suggests that pregnancy can be successfully carried to term in selected women with MDS, particularly when disease stability is established prior to conception.