Abstract
Objectives: Use of oral contraceptive pills (OCP) increases the risk of cerebral venous sinus thrombosis (CVST). Whether this risk varies by type, duration, and other forms of hormonal contraceptives is largely unknown. This systematic review and meta-analysis update the current state of knowledge.Methods: We performed a search to identify all published studies on the association between hormonal contraceptive use and risk of CVST in women aged 15–50 years.Results: Of 861 studies reviewed, 11 were included. The pooled odds of developing CVST in women aged 15–50 years taking OCPs was 7.59 times higher compared to women not taking OCPs (OR = 7.59, 95% CI 3.82–15.09). Data are insufficient to make conclusions about duration of use and other forms of hormonal contraceptives.Conclusion: Oral contraceptive pills use increases the risk of developing CVST in women of reproductive age. Future studies are required to determine if duration and type of hormonal contraceptives modify this risk.
Highlights
Cerebral venous sinus thrombosis (CVST) is a form of stroke whereby thrombosis occurs in the cerebral venous sinuses or veins
The pooled odds of developing CVST in women aged 15–50 years taking oral contraceptive pills (OCP) was 7.59 times higher compared to women not taking OCPs (OR = 7.59, 95% confidence interval (95% CI) 3.82–15.09)
Oral contraceptive pills use increases the risk of developing CVST in women of reproductive age
Summary
Cerebral venous sinus thrombosis (CVST) is a form of stroke whereby thrombosis occurs in the cerebral venous sinuses or veins. The incidence of CVST has been estimated at three to five cases per million population per year [1, 2]. This represents about 0.5– 1% of all strokes [1, 2]. Many of the previous studies were underpowered or had varying inclusion and exclusion criteria and did not adjust for the presence of other risk factors when evaluating the association between OCP use and CVST. A prior systematic review and meta-analysis were performed on this association, it was conducted over 7 years ago and did not make a distinction between those with thrombophilia and those without thrombophilia in the assessment of OCP use and risk of CVST [5]. This review did neither evaluate information on type of OCP used and risk of CVST nor risk of CVST with the use of other hormonal contraceptives
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