At my last company we built an internal build/deployment tool and dashboard. Because we serviced a lot of clients and a number of them were .NET projects, our tool had to be deployed to Windows. There were a couple of devs who did their work in Windows and I did mine in OS X, using a VM to test for compatability.
There was always something wrong, usually in some plugin that assumed weird things about file paths. I think we submitted like 25-30 PRs to various plugins, a number of which weren't taken in because they didn't want to maintain Windows compatability.
One of the bigger issues we had was in fronting the application with IIS and logging it. It's been about 18+ months now, so the specific are foggy but our application took a long time to be resilient on Windows, to the extent that we ran the same code deployed to Windows and Ubuntu for about 8 months and primarily everyone used the Ubuntu server because it was always working.
Windows is very often not even a tested platform for most plugins, which leads to very weird things very deep in code that take quite a while to figure out.
With all of that, the Node community moves fast, so you could hope life's better now than 18 months ago- but I doubt that the community suddenly decided to add Windows to their development cycle.
In the end, we wound up with a very stable, very awesome build and deployment platform that worked great for us- and unlike all the other options we looked at, handled the gamut of C#, Java, PHP, front end only, whatever projects we had and deployed them in all the ways they'd want to be deployed. 18 months on, with little maintenance the system is supposedly still going strong- so developing Node on Windows is possible and you can make it stable, but you will very likely be doing a lot of work on other people's projects that you want to use, and you'll need to be okay with that.