Objective To inform on delivery outcomes achieved in congenital heart disease (CHD) patients by the Cuban National Programme for pregnancy and heart disease. Methods Single-centre retrospective study on a prospectively collected cardiac pregnancy database at a tertiary referral hospital (January 2000–May 2017). Primary outcomes: pregnancy duration, outcome, maternal/fetal complications. Results Four hundred sixty-seven pregnancies in 462 recorded cases reached third trimester. Median age: 25 (21–29) years. Patients presented in NYHA class I (97%, n = 453) or II (3%, n = 14), 6% (n = 27) had arrhythmias, 1% (n = 4) had co-morbidities, 1% (n = 4) had impaired left ventricular function. There were 464 singleton pregnancies and 3 twin pregnancies. Of the singleton pregnancies, one resulted in stillbirth (0.2%). The rest were live births (n = 463), median weight 3200 (2900–3421) grams. Median pregnancy duration: 39.1 (38.6–40) weeks. Caesarean rate: 34% (n = 156). All twin pregnancies (n = 3) resulted in live births (n = 6) via caesarean section, of median weight 2710 (2458–2850) grams and median pregnancy duration 37 (36–38) weeks. Maternal cardiovascular complications (< 0.5%, n = 2), and obstetric complications (14%, n = 67) did not result in any mortality. Small-for-gestational-age was the commonest neonatal complication (10%, n = 48), with zero mortality. Three neonates (1%) had CHD. Post-delivery maternal NYHA functional status: class I in 84% (n = 393), class II in 16% (n = 73), and class III in one patient (< 0.5%). Conclusion In middle-income countries management of CHD pregnancies according to existing guidelines can achieve good maternal and fetal outcomes.