Perinatal stroke in baby, prothrombotic gene in mom: does this affect maternal health insurance?
BACKGROUND
Maternal prothrombotic disorders may contribute to stroke in the fetus before and during birth. Many of the mothers of children with perinatal stroke have no previous history of pathologic thrombosis.


OBJECTIVE
To determine if finding the Factor V Leiden mutation, prothrombin 20210 G-A gene defect, or methylene tetrahydrofolate reductase C677T mutation in an asymptomatic mother of a child with perinatal stroke would affect that mother's ability to obtain health insurance.


METHODS
1) The authors reviewed the literature on genetic prothrombotic risk factors and health insurance. 2) The authors surveyed the 17 largest insurance carriers in Indiana to find if diagnosing genetic prothrombotic risk factors in asymptomatic mothers of children with perinatal stroke would affect the mothers' health insurance status.


RESULTS
Three articles on genetic prothrombotic risk factors and insurance were identified. Twelve of 17 insurance companies responded to our survey; three had policies on genetic testing. Most companies refused to provide clear, useful information on their policies regarding these risk factors.


CONCLUSIONS
The authors are currently unable to counsel their patients' families on the long-term insurance implications of screening for genetic prothrombotic risk factors. The insurance implications of diagnosing healthy women with genetic prothrombotic risk factors need further study.
Golomb
Meredith R
MR
Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA. mgolomb@iupui.edu
Garg
Bhuwan P
BP
Walsh
Laurence E
LE
Williams
Linda S
LS
D001778:Blood Coagulation Disorders / Q000150:complications / Q000191:economics* / Q000235:genetics; D005165:Factor V / Q000235:genetics; D005260:Female; D005315:Fetal Diseases / Q000235:genetics / Q000503:physiopathology; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005820:Genetic Testing / Q000941:ethics / Q000592:standards / Q000639:trends; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D019458:Insurance Coverage / Q000941:ethics / Q000592:standards / Q000639:trends; D007348:Insurance, Health / Q000941:ethics* / Q000592:standards / Q000639:trends; D007407:Interviews as Topic; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D009154:Mutation / Q000235:genetics; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000191:economics* / Q000235:genetics; D011516:Prothrombin / Q000235:genetics; D012307:Risk Factors; D020521:Stroke / Q000191:economics* / Q000235:genetics* / Q000503:physiopathology
C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin; D042965:Methylenetetrahydrofolate Reductase (NADPH2)