ArticleThrombosis research2025
Association between combined oral contraceptive prescription and cervical artery dissection: A retrospective cohort study.
Article in Thrombosis research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Association between spinal manipulative therapy and cervical artery dissection in patients with neck pain or headache: a retrospective cohort study.Chiropractic & manual therapies · 2026Article
- Partial Horner's Syndrome Secondary to Carotid Dissection With an Associated Folate Deficiency.Cureus · 2025Article
- Association between combined oral contraceptive prescription and cervical artery dissection: A retrospective cohort study.Thrombosis research · 2025Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundTo date, research has identified positive associations between combined oral contraceptives (COCs) and adverse vascular events, however, evidence regarding the possible association with cervical artery dissection (CeAD) remains limited. We tested the hypothesis of a positive association between COCs and CeAD within one year following COC initiation compared to matched controls initiating intrauterine devices (IUDs), as measured by risk ratio (RR).
methodsWe queried de-identified United States health records data (TriNetX, Inc.) from 2014 to 2024 for females aged 15-50 years without previous cerebrovascular disease or CeAD, creating mutually exclusive cohorts initiating either COCs or IUDs. We used propensity matching to control for variables associated with CeAD. Our primary outcome included the RR for CeAD within one year follow-up. We secondarily explored cumulative CeAD incidence and RR of stroke, also examining outcomes for females with ≥2 COC prescriptions (COC2).
resultsAfter matching there were 214,020 patients per cohort (mean age 31 years). The incidence and risk of CeAD was greater among those prescribed COCs compared to matched controls with IUDs [95 % CI] (COCs: 0.016 %, IUDs: 0.008 %; RR 1.94 [1.10,3.43]; P = 0.0195). A similar association was observed for stroke (COCs: 0.106 %, IUDs: 0.057 %; RR = 1.86 [1.49,2.32]; P < 0.0001). The secondary COC2 analysis revealed similar findings.
conclusionsThe present findings suggest that females prescribed COCs have an increased risk of CeAD and stroke compared to matched controls using IUDs. These observations should be viewed as preliminary, require corroboration by other studies, and in isolation do not replace the broader clinical and shared decision-making regarding contraceptive use.
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