Oral Contraception and Increased Risk of Cerebral Ischemia or Thrombosis

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Abstract
A case–control study was conducted to determine the relation between the use of oral contraceptives and the occurrence of stroke in young women. During a two-year period between 1969 and 1971, neurologists from 12 university hospitals identified various types of cerebrovascular disease in 598 nonpregnant women 15 to 44 years of age. Control subjects matched for age, sex and race were chosen from the discharge rosters of the same hospitals and from women residing in the same neighborhood as the patients with stroke. A detailed history of contraceptive practices was obtained by lay interviewers from approximately 70 per cent of patients and controls. The current use of oral contraceptives was considerably increased in women with thrombotic strokes as compared with their controls and somewhat increased in women with hemorrhagic strokes. The relative risk of cerebral ischemia or thrombosis was estimated to be about nine times greater for women who use oral contraceptives than for those who do not. (N Engl J Med 288:871–878, 1973)