Influence of pregnancy and oral contraception on the incidence of strokes in women of childbearing age

ABSTRACT

Ischaemic strokes are not uncommon in women aged 15-45. Over 500 carotid strokes were fully investigated between 1956 and 1965; 146 (29.2 percent) of the patients were aged 15-45 and 44.5 percent of these were women. Since oral contraceptives became available the proportion of non-pregnant women among the cases investigated in this age group has not increased; 40 of the 42 non-pregnant women with strokes are known not to have been taking oral contraceptives. There is no obvious difference between strokes reported in association with oral contraceptives and those occuring in other women in this age-group; thus there is no evidence from this study that oral contraceptives are responsible for producing or precipitating cerebral arterial occulusion in young women. Of the 65 women with strokes, in this age-group a third were pregnant of puerperal; these pregnant patients had a considerably higher mortality than men or non-pregnant women women with strokes. Full investigation of cases of non-haemorrhagic hemiplegia in pregnancy shows that two-thirds are due to major arterial occlusion, and that cerebral venous thrombosis is not the usual cause, as is commonly stated. (AU)