CHD affect approximately 1% of live births globally and are the most common congenital anomaly. Contemporary data on CHD risk in offspring of affected mothers remains limited. This study evaluated CHD incidence in offspring of mothers with CHD at a southeastern U.S. academic medical centre.

We conducted a retrospective review of patients with CHD who received prenatal care between 2015 and 2023 at a multidisciplinary Cardio-Obstetrics clinic. Patients with acquired heart disease, syndromic or inherited CHD, and deliveries at outside hospitals with missing delivery data were excluded. The primary outcome was infant CHD incidence, confirmed by postnatal echocardiography. Secondary outcomes were neonatal intensive care unit admission, early in-hospital cardiac surgery, and in-hospital infant mortality.

A total of 186 mothers with 195 pregnancies and 198 infants were included. CHD was diagnosed in 16 infants (8.1%), most commonly ventricular septal defect. Of affected infants, none required early in-hospital surgery, and one experienced in-hospital mortality, though this infant had severe extracardiac anomalies concerning an underlying genetic syndrome.

The incidence of CHD among offspring of mothers with CHD in our cohort was higher than the general population; however, the majority of defects were non-critical and did not require early intervention. These findings offer important context for prenatal counselling and tailored fetal/neonatal echocardiography screening in this high-risk population.

The growing number of women with CHD presents unique challenges, including those related to pregnancy, which can lead to significant morbidity and mortality. We sought to evaluate the perception of paediatric cardiologists towards the reproductive health of women with CHD.

Paediatric cardiologists in the United States of America were invited to participate in a cross-sectional, anonymous survey. Information solicited included knowledge of contraceptive methods, experience caring for pregnant women with CHD, and referral patterns including the utilisation of high-risk obstetric and adult CHD specialists.

A total of 110 cardiologists responded – 90% with an academic affiliation and 70% with ⩾10 years’ clinical experience. Although 95% reported an understanding of available contraceptive options, 32% did not feel comfortable recommending birth control. Pregnant women with CHD were seen by 83% of responders, and 37% of the responders reported a low level of comfort in doing so. Among all respondents, 73% indicated that they would refer a pregnant CHD patient to a high-risk obstetrician and 60% to an adult CHD specialist – almost all respondents would not transfer care to a non-adult CHD cardiologist. Among paediatric cardiologists, 81% indicated that they would resume their patient’s care following delivery.

Our results illustrate a gap in what physicians feel should be done and the care that they feel comfortable providing pregnant women with CHD. As this population continues to grow, training adult CHD cardiologists with specific skills in reproductive health in women with CHD is the first step to closing the care gap that exists in the management of such patients.