{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:20:05Z","timestamp":1787653205529,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Combined oral contraceptives (COCs) are often avoided in women with migraine because of concerns about ischemic stroke. However, the risk associated with low\u2010dose and ultra\u2010low\u2010dose COCs remains unclear. We aimed to evaluate the risk of ischemic stroke using contemporary low\u2010dose COC use among women with migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the JMDC claims database in Japan. Women aged 20\u201349\u2009years diagnosed with migraine between April 2012 and March 2024 were included. Exposure was defined as administration of COCs containing estrogen doses of 20 and 35\u2009\u03bcg, whereas the comparison group was defined as discontinued use after the initial prescription. The hazard ratios (HRs) for ischemic stroke were estimated using Cox regression, and odds ratios (ORs) were calculated using case\u2010time\u2010control analysis to evaluate short\u2010term associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 215\u2009536 women with migraine, 453 experienced ischemic strokes during follow\u2010up. Among COC continuing users, the 5\u2010year cumulative incidence rates of ischemic stroke were 0.11% (95% CI: 0.01% to 0.81%), and the HR was 0.10 (95% CI: 0.01 to 1.36). The OR in the case\u2010time\u2010control analysis was 0.38 (95% CI: 0.03 to 5.13).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This large claims database study found no significant increase in the risk of ischemic stroke or other outcomes associated with low\u2010dose COC use in women with migraine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70441","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T10:06:05Z","timestamp":1786529165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Risk of Ischemic Stroke With Low\u2010Dose Combined Oral Contraceptives in Women With Migraine: A Nationwide Claims Database Study"],"prefix":"10.1111","volume":"52","author":[{"given":"Sho","family":"Koyanagi","sequence":"first","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8558-4950","authenticated-orcid":false,"given":"Takanori","family":"Yanai","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2040-5913","authenticated-orcid":false,"given":"Yoshihide","family":"Inayama","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"},{"name":"Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0671-5376","authenticated-orcid":false,"given":"Sachiko","family":"Tanaka\u2010Mizuno","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"},{"name":"Laboratory of Epidemiology and Prevention, Kobe Pharmaceutical University  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7477-4071","authenticated-orcid":false,"given":"Koji","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(25)00402-8"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000265415.18382.fb"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102411427599"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2010.191"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b3914"},{"issue":"8","key":"e_1_2_11_7_1","article-title":"Combined Oral Contraceptives: The Risk of Myocardial Infarction and Ischemic Stroke","volume":"2015","author":"Roach R. 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