Yes, a cushingoid appearance can affect pregnancy. Elevated cortisol levels can lead to complications such as gestational diabetes, hypertension, and preeclampsia. These conditions require careful monitoring and management to ensure the health and safety of both the mother and the fetus. Pregnant women with Cushing's syndrome or those on long-term glucocorticoid therapy should be under the close supervision of both an endocrinologist and a gynecologist.