1. Template University Medical Center Groningen Marlies A.M. Kampman, Ali Balci, Krystyna M. Sollie-Szarynska, Barbara J.M. Mulder, M.A. Oudijk, Jolien W. Roos-Hesselink, Arie P.J. van Dijk, Monique W.M. de Laat, Katia M. Bilardo, Petronella G. Pieper On behalf of the ZAHARA II investigators Pregnancy Outcome and Delivery in Women with Congenital Heart Disease.

2. Pregnancy outcome and delivery University Medical Center Groningen Purpose and Methods Purpose: To assess mode of delivery in pregnant women with congenital heart disease (CHD) and compare to healthy controls. To observe the prevalence of obstetric and neonatal complications in pregnant women with CHD and compare to healthy controls. Methods: Follow up at 20 & 32 weeks gestation Review of medical records and delivery reports

3. Pregnancy outcome and delivery University Medical Center Groningen Results Mode of delivery 213 pregnancies in women with CHD, 70 healthy controls CHD Healthy Vaginal delivery Elective CS Secondary CS P = 0.087 P = 0.002 P = 0.60 36.6%

4. Pregnancy outcome and delivery University Medical Center Groningen Results Obstetric complications

5. Pregnancy outcome and delivery University Medical Center Groningen Results Neonatal complications P= 0.01 P= 0.012

6. Pregnancy outcome and delivery University Medical Center Groningen Results Neonatal complications Modified WHO risk class 3 & 4 are associated with lower birth weight.

7. Pregnancy outcome and delivery University Medical Center Groningen Conclusion The majority of women with CHD deliver vaginally and only a minority undergoes ceasarean section for cardiac reasons. Children of women with CHD have lower birth weight and are more often small for gestational age. Modified WHO risk class 3 & 4 are associated with lower birth weight.

8. Pregnancy outcome and delivery University Medical Center Groningen

9. Pregnancy outcome and delivery University Medical Center Groningen Study population