Evidence map›Paper›PMID 39923282›Full record

ArticleThrombosis research2025

Association between combined oral contraceptive prescription and cervical artery dissection: A retrospective cohort study.

Robert J Trager, Catherine P Haering, Anthony N Baumann, Debbie S Wright

Abstract read
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Robert J TragerConnor Whole Health, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Family Medicine and Community Health, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Department of Biostatistics and Bioinformatics Clinical Research Training Program, Duke University School of Medicine, Durham, NC, USA. Electronic address: Robert.Trager@case.edu.
Catherine P HaeringDepartment of Reproductive Endocrinology and Infertility, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Anthony N BaumannCollege of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA; Department of Rehabilitation Services, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Debbie S WrightMSCR Student, Parker University, Dallas, TX, USA; Private practice, The Grove Health and Wellness, Courtenay, BC, Canada.

Funding

Clinical and Translational Science Collaborative of Northern Ohio, Catalyzing Linkages to Equity in Health (CLE Health)UM1TR004528 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI GRACE A MCCOMSEY · 2023 to 2026
$32.1M
NCATS NIH HHS UM1 TR004528
6 · The paper itself

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.

Indexed as

Contraceptives, Oral, CombinedAdolescentAdultCohort StudiesFemaleHumansMiddle AgedRetrospective StudiesYoung AdultContraceptives, Oral, CombinedCardiovascular diseasesCerebrovascular disordersContraceptive agentsContraceptive devicesEthinyl estradiolProgestin

Identifiers

PMID39923282
PMCPMC13163211

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.