A Portuguese multicenter retrospective study analyzed 12 pregnancies in 10 women with idiopathic inflammatory myopathies (IIMs) in four tertiary centers between 2009–2025. Phenotypes included overlapping myositis (4 cases), antisynthetase syndrome (3), dermatomyositis (3), immune-mediated necrotizing myopathy (1), and polymyopathy (1). Autoantibodies specific or associated with myositis were detected in 91.7% of cases, most often anti-Ro52 and anti-Jo-1. Remission of the disease at conception was in 9 pregnancies (75%). Adverse pregnancy outcomes (APOs) occurred in 6 pregnancies (50%): 4 miscarriages, 1 stillbirth, and 1 fetal growth restriction with a small-for-gestational-age neonate; out of 12 pregnancies there were 7 live births. All APOs occurred in flare-ups, none in stable condition. The most serious complications (stillbirth, growth restriction) were in the mother with antisynthetase syndrome and high anti-Jo-1 titers; no preeclampsia, eclampsia, congenital anomalies, or neonatal lupus were reported.[1]