SENATE, No. 2305

STATE OF NEW JERSEY

INTRODUCED DECEMBER 1, 1997

By Senator CAFIERO

An Act concerning testing pregnant women, amending P.L.1995, c.174 and supplementing Title 26 of the Revised Statutes.

    Be It Enacted by the Senate and General Assembly of the State of New Jersey:

    1. Section 2 of P.L.1995, c.174 (C.26:5C-16) is amended to read as follows:

    2. a. A physician or other health care practitioner who is the primary caregiver for a pregnant woman or a woman who seeks treatment within four weeks of giving birth, shall, in accordance with guidelines developed by the commissioner, test the woman for HIV, provide the woman with information about HIV and AIDS, and also inform the woman of the benefits of being tested for HIV [and present her with the option of being tested] and of the importance of treatment for HIV infection during and after pregnancy. The woman shall, on a form and in a manner prescribed by the commissioner, acknowledge receipt of the information [and indicate her preference regarding testing. A woman shall not be denied appropriate prenatal or other medical care because she decides not to be tested for HIV].

    b. The commissioner shall establish guidelines regarding notification to a woman whose test result is positive, and to provide, to the maximum extent possible, for counseling about the significance of the test result.

    c. Information about a woman which is obtained pursuant to this section shall be held confidential in accordance with the provisions of P.L.1989, c.303 (C.26:5C-5 et seq.).

(cf: P.L.1995, c.174, s.2)

    2. (New section) a. A physician or other health care practitioner who is the primary caregiver for a pregnant woman, shall, in accordance with guidelines developed by the Commissioner of Health and Senior Services, test the woman for Group B Streptococci, provide the woman with information about Group B Streptococcal infection, and also inform the woman of the benefits of being tested for Group B Streptococci and of the importance of treatment during pregnancy. The woman shall, on a form and in a manner prescribed by the commissioner, acknowledge receipt of the information.

    b. The commissioner shall establish guidelines regarding notification to a woman whose test result is positive, and to provide, to the maximum extent possible, for counseling about the significance of the test result.

    3. This act shall take effect immediately.

STATEMENT

    This bill requires the testing of pregnant women for HIV and Group B Streptococci.

    With regard to testing for HIV, the bill amends P.L.1995, c.174 (C.26:5C-15 et seq.) by requiring that pregnant women be tested. The bill deletes language in P.L.1995, c.174 that gave pregnant women the option of being tested for HIV and required them to indicate their preference regarding testing, since this bill mandates the HIV testing. The bill also amends P.L.1995, c.174 to require the physician or other health care practitioner to inform the pregnant woman of the importance of treatment for HIV infection during and after pregnancy.

    The risk of HIV infection to newborns can be significantly reduced when the mother receives zidovudine (AZT) therapy. According to preliminary results of a trial sponsored by the National Institute of Allergy and Infectious Diseases, zidovudine (AZT) therapy has reduced by two-thirds the risk of transmission of the virus from HIV-infected pregnant women to their babies.

    In addition, the bill requires that pregnant women be tested for Group B Streptococci. Similar to the provisions regarding HIV testing, the bill requires that:

∙   a pregnant woman be provided with information about Group B Streptococcal infection, the benefits of being tested and of the importance of treatment during pregnancy;

∙   a pregnant woman acknowledge receipt of the information on a form and in a manner prescribed by the commissioner; and

∙   the commissioner establish guidelines regarding notification to a pregnant woman whose test result is positive and provide for counseling about the significance of the test result.

    Group B Streptococci can cause bacterial infections in newborns and these infections may lead to permanent neurologic injury or even death. Both the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have endorsed testing all pregnant women for Group B Streptococci shortly before delivery, and providing preventive antibiotics during delivery to those who tested positive. Group B Streptococci, which can be present in either the intestine or urinary tract of a pregnant woman without showing any visible signs of infection, are transmitted from the mother to the child prior to or during delivery. This occurs normally in about 5 percent to 25 percent of pregnant women.

    The likelihood of transmitting the bacteria and causing infection increases under certain conditions, such as a premature delivery, prolonged labor, or fever in the mother at the time of delivery. A different but equally endorsed approach to preventing Group B Streptococcal infections in newborns is to provide preventive antibiotics during delivery to women delivering a premature infant, or having prolonged labor or a fever. However, it is believed that testing all pregnant women, as required under the provisions of this bill, would reduce overall the risk of causing these potentially fatal infections in newborns because the treatment would not be limited to only higher risk pregnancies.

Requires HIV and Group B Streptococci testing of pregnant women.