Context

Most women with congenital heart disease can now expect to reach childbearing age. Collectively, congenital malformations are the most common form of heart disease in pregnant women and the leading cardiac cause of maternal morbidity and mortality.1 Over the past two decades, several studies have characterised pregnancy-related changes, assessed maternal and fetal complications and identified related high-risk features. However, risk-stratification attempts have largely focused on acute pregnancy-related complications. Little is known about cardiac outcomes beyond the immediate peripartum setting. It is in this context that Balint and colleagues systematically assessed the frequency and determinants of adverse maternal cardiac events late after pregnancy in women with a broad spectrum of congenital heart malformations.