Prevention and management of infectious diseases in pregnant women with haematological malignancies.

The incidence of haematological malignancies during pregnancy ranges from 4·0 to 15·8 cases per 100 000 pregnancies, with Hodgkin lymphoma, acute leukaemia, and aggressive B-cell non-Hodgkin lymphoma being the most frequent subtypes. Although survival rates are similar to those in patients who are not pregnant with similar disease profiles, pregnant women face higher risks of maternal morbidity, along with adverse obstetric and neonatal outcomes. Their management, therefore, requires a carefully balanced approach that minimises obstetric risks and ensures effective oncological control. Physiological adaptations of pregnancy can obscure the clinical presentation of sepsis, modulate the course of infections, and, through altered pharmacokinetics, complicate antimicrobial therapy. Safety data on antimicrobials are scarce and concerns about teratogenicity further constrain therapeutic decisions. As a result, infection management in pregnant women requires tailored approaches to diagnosis, antimicrobial therapy, and fetal monitoring. This Review summarises the physiological changes influencing infection risk and treatment efficacy in pregnant women with haematological malignancies; it outlines key challenges in prevention and management and identifies crucial knowledge gaps to guide practice and research in this complex interplay.