Does low dose contraceptive pills increase stroke rate? A cross sectional study in North-West Iran

Abstract

Objectives: Several reports concern the relationship between low dose oral contraceptive pills (OCP) and the occurrence of strokes. The present study investigates this relationship in childbearing stroke women admitted to university referral hospitals in North-West Iran.

Methodology: One hundred seventy eight female patients between 15 and 44 years of age who were admitted to two referral University Hospitals in a six years period were evaluated in this descriptive-analytical study. Data concerning the use of OCP and other risk factors were recorded. The OCP usage data were compared between the patients and the matched normal population.

Results: The average age of the patients was 35.5±7.4 years. Seventy three patients were admitted with arterial stroke, 15 patients had cardioembolic origin, 39 patients with venous stroke and 46 patients with hemorrhagic stroke, 45.2%, 20%, 59% and 30.4% of them used OCP respectively. Approximately 26.3% of the matched female population of childbearing age used OCP and there was a significant correlation between venous stroke (P < 0.0001) and atherothrombotic stroke (P < 0.0001) with OCP usage. Migraine was the only risk factor that significantly correlated with OCP consumption and stroke. In addition, the data concerning OCP use in the stroke patients, without any other risk factors (32/71: 45%), demonstrated a significant difference comparing the matched population (P < 0.0001).

Conclusion: OCP usage increases the risk of venous and atherothrombotic stroke in North-West of Iran, particularly in those individuals who suffer concurrent migraine.