Raskind-Hood C, Saraf A, Riehle-Colarusso T, et al. - Given the lack of a US population-based systems to estimate pregnancy frequency or complications among women with congenital heart defects (CHDs), researchers selected cases from three surveillance sites: Emory University; Massachusetts Department of Public Health; and New York State Department of Health. They grouped cases into one of five mutually exclusive CHD severity categories collapsed to severe vs not severe; among women, aged 11-50 years, with a CHD-associated ICD-9-CM code, pregnancy, gestational complications, and non-gestational comorbidities were captured using specific ICD-9-CM codes. Among women with severe CHDs, the age-adjusted proportion pregnancy rates observed over three years ranged from 10.0%–24.6%, and 14.2%–21.7% for women with non-severe CHDs. More non-cardiovascular comorbidities were seen in pregnant women with CHDs of any severity vs non-pregnant women with CHDs. Variations in insurance type were seen by site and pregnancy status. Pregnancy and complications may be occurring in a substantial number of women with CHDs, was suggested by the reported US population-based, multi-site estimates of pregnancy among women with CHD. An essential public health issue is the reproductive health of women with CHD, given the expanding adult population with CHDs.