BackgroundWomen with congenital heart disease (CHD) are surviving into adulthood, with more undergoing pregnancy.MethodsRetrospective review of the Vizient database from 2017–2019 for women 15–44 years old with moderate, severe or no CHD and vaginal delivery or caesarean section. Demographics, hospital outcomes and costs were compared.ResultsThere were 2,469,117 admissions: 2,467,589 with no CHD, 1277 with moderate and 251 with severe CHD. Both CHD groups were younger than no CHD, there were fewer white race/ethnicity in the no CHD group and more women with Medicare in both CHD groups compared to no CHD. With increasing CHD severity there was an increase in length of stay, ICU admission rates and costs. There were also higher rates of complications, mortality and caesarean section in the CHD groups.ConclusionPregnant women with CHD have more problematic pregnancies and understanding this impact is important to improve management and decrease healthcare utilization.