This umbrella review aims to consolidate existing knowledge on the association between autoimmune conditions and adverse pregnancy outcomes. The study searched Medline, Embase, and Cochrane databases from inception to December 2023, screening 2743 potential reviews. After exclusions, 32 systematic reviews were included, covering 709 primary studies. The reviews reported associations between 12 autoimmune conditions and 16 adverse pregnancy outcomes. Key findings include: - Higher risk of miscarriage in women with Sjögren’s syndrome (RR 8.85) and systemic lupus erythematosus (SLE) (OR 4.90). - Increased risk of pre-eclampsia in women with type 1 diabetes mellitus (T1DM) (OR 4.19) and SLE (OR 3.20). - Higher risk of diabetes during pregnancy in women with inflammatory bowel disease (IBD) (OR 2.96). - Increased risk of intrauterine growth restriction in women with systemic sclerosis (OR 3.20) and coeliac disease (OR 1.71). - Preterm birth associated with T1DM (OR 4.36) and SLE (OR 2.79). - Low birth weight in women with SLE or systemic sclerosis (OR 5.95 and 3.80, respectively). - Higher risk of stillbirth in women with T1DM (OR 3.97), IBD (OR 1.57), and coeliac disease (OR 1.57). - T1DM in women was associated with a 32% lower odds of small for gestational age baby (OR 0.68). The review highlights the need for better preconception to postnatal care for women with autoimmune conditions and identifies gaps in research, particularly for conditions like multiple sclerosis and Sjögren’s syndrome. Further studies are required to address these gaps and develop more evidence-based guidelines.This umbrella review aims to consolidate existing knowledge on the association between autoimmune conditions and adverse pregnancy outcomes. The study searched Medline, Embase, and Cochrane databases from inception to December 2023, screening 2743 potential reviews. After exclusions, 32 systematic reviews were included, covering 709 primary studies. The reviews reported associations between 12 autoimmune conditions and 16 adverse pregnancy outcomes. Key findings include: - Higher risk of miscarriage in women with Sjögren’s syndrome (RR 8.85) and systemic lupus erythematosus (SLE) (OR 4.90). - Increased risk of pre-eclampsia in women with type 1 diabetes mellitus (T1DM) (OR 4.19) and SLE (OR 3.20). - Higher risk of diabetes during pregnancy in women with inflammatory bowel disease (IBD) (OR 2.96). - Increased risk of intrauterine growth restriction in women with systemic sclerosis (OR 3.20) and coeliac disease (OR 1.71). - Preterm birth associated with T1DM (OR 4.36) and SLE (OR 2.79). - Low birth weight in women with SLE or systemic sclerosis (OR 5.95 and 3.80, respectively). - Higher risk of stillbirth in women with T1DM (OR 3.97), IBD (OR 1.57), and coeliac disease (OR 1.57). - T1DM in women was associated with a 32% lower odds of small for gestational age baby (OR 0.68). The review highlights the need for better preconception to postnatal care for women with autoimmune conditions and identifies gaps in research, particularly for conditions like multiple sclerosis and Sjögren’s syndrome. Further studies are required to address these gaps and develop more evidence-based guidelines.