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Use of low-dose oral contraceptives and stroke in young women.
Ann Intern Med. 1997 Oct 15; 127(8 Pt 1):596-603.AIM

Abstract

BACKGROUND

Low-dose oral contraceptives are widely used, but there are limited data on the cerebrovascular risks associated with these medications.

OBJECTIVE

To determine whether use of low-dose oral contraceptives influences the risk for stroke.

DESIGN

Population-based case-control study.

SETTING

Women 18-44 years of age who resided in western Washington State between 1991 and 1995.

PARTICIPANTS

Patients with ischemic stroke (n = 60), hemorrhagic stroke (n = 102), and other types of stroke (n = 11) and controls identified through random-digit dialing (n = 485).

MEASUREMENTS

Details about oral contraceptive use and other risk factors for stroke were obtained through in-person interviews.

RESULTS

The estimated incidences of hemorrhagic stroke and ischemic stroke were 6.4 and 4.3 per 100,000 women-years, respectively. Compared with women who had never used oral contraceptives (after adjustment for risk factors for stroke), current users of low-dose oral contraceptives had estimated odds ratios of 0.93 (95% CI, 0.37 to 2.31) for hemorrhagic stroke and 0.89 (CI, 0.27 to 2.94) for ischemic stroke. Compared with past users of oral contraceptives, current users had odds ratios of 1.41 (CI, 0.67 to 2.96) for hemorrhagic stroke and 1.37 (CI, 0.49 to 3.81) for ischemic stroke. For past users compared with never users, the odds ratios were 0.59 (CI, 0.30 to 1.18) for hemorrhagic stroke and 0.57 (CI, 0.25 to 1.32) for ischemic stroke. The odds ratio for hemorrhagic stroke in current users of low-dose oral contraceptives containing norgestrel or levonorgestrel was elevated (3.23 [CI, 1.24 to 8.41]). Among patients with hemorrhagic stroke, the odds ratio for aneurysmal bleeding associated with current use of low-dose oral contraceptives containing norgestrel or levonorgestrel was 4.46 (CI, 1.58 to 12.53).

CONCLUSION

The overall risk for stroke and type of stroke was not increased among current users of low-dose oral contraceptives in the study population. Larger studies are needed to clarify both the relation of risk for stroke to past use of oral contraceptives and the possible association between current use of norgestrel-containing oral contraceptives and hemorrhagic stroke.

Authors+Show Affiliations

University of Washington, Seattle, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9341057

Citation

Schwartz, S M., et al. "Use of Low-dose Oral Contraceptives and Stroke in Young Women." Annals of Internal Medicine, vol. 127, no. 8 Pt 1, 1997, pp. 596-603.
Schwartz SM, Siscovick DS, Longstreth WT, et al. Use of low-dose oral contraceptives and stroke in young women. Ann Intern Med. 1997;127(8 Pt 1):596-603.
Schwartz, S. M., Siscovick, D. S., Longstreth, W. T., Psaty, B. M., Beverly, R. K., Raghunathan, T. E., Lin, D., & Koepsell, T. D. (1997). Use of low-dose oral contraceptives and stroke in young women. Annals of Internal Medicine, 127(8 Pt 1), 596-603.
Schwartz SM, et al. Use of Low-dose Oral Contraceptives and Stroke in Young Women. Ann Intern Med. 1997 Oct 15;127(8 Pt 1):596-603. PubMed PMID: 9341057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of low-dose oral contraceptives and stroke in young women. AU - Schwartz,S M, AU - Siscovick,D S, AU - Longstreth,W T,Jr AU - Psaty,B M, AU - Beverly,R K, AU - Raghunathan,T E, AU - Lin,D, AU - Koepsell,T D, PY - 1997/10/27/pubmed PY - 2001/3/28/medline PY - 1997/10/27/entrez KW - Americas KW - Biology KW - Case Control Studies KW - Cerebrovascular Effects KW - Contraception KW - Contraceptive Methods--side effects KW - Developed Countries KW - Family Planning KW - North America KW - Northern America KW - Oral Contraceptives, Low-dose--side effects KW - Oral Contraceptives--side effects KW - Physiology KW - Research Methodology KW - Research Report KW - Risk Factors KW - Studies KW - United States KW - Washington SP - 596 EP - 603 JF - Annals of internal medicine JO - Ann Intern Med VL - 127 IS - 8 Pt 1 N2 - BACKGROUND: Low-dose oral contraceptives are widely used, but there are limited data on the cerebrovascular risks associated with these medications. OBJECTIVE: To determine whether use of low-dose oral contraceptives influences the risk for stroke. DESIGN: Population-based case-control study. SETTING: Women 18-44 years of age who resided in western Washington State between 1991 and 1995. PARTICIPANTS: Patients with ischemic stroke (n = 60), hemorrhagic stroke (n = 102), and other types of stroke (n = 11) and controls identified through random-digit dialing (n = 485). MEASUREMENTS: Details about oral contraceptive use and other risk factors for stroke were obtained through in-person interviews. RESULTS: The estimated incidences of hemorrhagic stroke and ischemic stroke were 6.4 and 4.3 per 100,000 women-years, respectively. Compared with women who had never used oral contraceptives (after adjustment for risk factors for stroke), current users of low-dose oral contraceptives had estimated odds ratios of 0.93 (95% CI, 0.37 to 2.31) for hemorrhagic stroke and 0.89 (CI, 0.27 to 2.94) for ischemic stroke. Compared with past users of oral contraceptives, current users had odds ratios of 1.41 (CI, 0.67 to 2.96) for hemorrhagic stroke and 1.37 (CI, 0.49 to 3.81) for ischemic stroke. For past users compared with never users, the odds ratios were 0.59 (CI, 0.30 to 1.18) for hemorrhagic stroke and 0.57 (CI, 0.25 to 1.32) for ischemic stroke. The odds ratio for hemorrhagic stroke in current users of low-dose oral contraceptives containing norgestrel or levonorgestrel was elevated (3.23 [CI, 1.24 to 8.41]). Among patients with hemorrhagic stroke, the odds ratio for aneurysmal bleeding associated with current use of low-dose oral contraceptives containing norgestrel or levonorgestrel was 4.46 (CI, 1.58 to 12.53). CONCLUSION: The overall risk for stroke and type of stroke was not increased among current users of low-dose oral contraceptives in the study population. Larger studies are needed to clarify both the relation of risk for stroke to past use of oral contraceptives and the possible association between current use of norgestrel-containing oral contraceptives and hemorrhagic stroke. SN - 0003-4819 UR - https://www.unboundmedicine.com/medline/citation/9341057/Use_of_low_dose_oral_contraceptives_and_stroke_in_young_women_ L2 - https://www.acpjournals.org/doi/10.7326/0003-4819-127-8_part_1-199710150-00003?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -