Background: The severe valve disease especially stenosis is a contraindication to conception according to WHO. This situation is still encountered in countries with a high rheumatic fever prevalence. The objective of this study was to determine the predictors of maternal cardiac, obstetric and neonatal complications. Methods: This is an observationnal study of all pregnant women with severe valvulopathy, delivered between 2010 and 2017. Results: We included 60 pregnancies in 54 women. Cardiac complications occurred in 37 patients (61%). In multivariate analysis, the predictors for these complications were parity (OR = 2.41, p = 0.023), revelation of valvulopathy by pregnancy (OR = 6.34, p = 0.025), severe mitral stenosis (OR = 6.84, p = 0.035) and systolic pulmonary arterial pressure (OR = 1.08, p = 0.01). Obstetrical complications were noted in 19 women (31.8%). The predictive factors for these complications were primiparity (OR = 5.22, p = 0.032), multiple valve disease (OR = 5.26, p = 0.028), systolic pulmonary arterial pressure (OR = 1.04, p = 0.04) and treatment with vitamin K antagonist (OR = 8.71, p = 0.04). Neonatal complications were noted in 39% of new-borns. The predictive factors for these complications were the occurrence of obstetric complications (OR = 15.48, p = 0.001) and the revelation of valvulopathy by pregnancy (OR = 6.95, p = 0.017). Conclusions: The revelation of valve disease by pregnancy is predictor of not only cardiac complication but also neonatal complications, thus valve disease screening during pre-conceptional counselling is crucial.