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BackgroundWe aimed to estimate, for the first time, the global burden of Group B Streptococcus (GBS), with regards to invasive disease in infants, as well as in pregnant and postpartum women, and fetal infection/stillbirth. Intrapartum antibiotic prophylaxis (IAP) is currently used for prevention of early onset infant disease in high-income contexts, but is difficult to implement globally, and may contribute to antimicrobial resistance. Maternal GBS vaccines are in development.MethodsFor 2015 live births, we used data from systematic reviews and meta-analyses (presented in separate papers in this GBS supplement) and a compartmental model to estimate:exposure to maternal GBS colonisation,cases of infant invasive GBS disease,deaths, anddisabilities.We applied incidence or prevalence data to estimate cases of maternal and fetal infection/stillbirth, and infants with invasive GBS disease presenting with neonatal encephalopathy (NE). We applied risk ratios to estimate numbers of preterm births attributable to GBS. Uncertainty was also estimated.Worldwide in 2015, we estimated 2 05 000 (uncertainty range [UR], 101000–327000) infants with early-onset disease and 1 14 000 (UR, 44000–326000) with late-onset disease, of whom a minimum of 7000 (UR, 0–19000) presented with neonatal encephalopathy. There were 90 000 (UR, 36000–169000) deaths in infants<3 months age, and, at least 10 000 (UR, 3000–27000) children with disability each year. There were 33 000 (UR, 13000–52000) cases of invasive GBS disease in pregnant or postpartum women, and 57 000 (UR, 12000–104000) fetal infections/stillbirths. Up to 3.5 million preterm births may be attributable to GBS. Africa accounted for 54% of estimated cases and 65% of all fetal/infant deaths. A maternal vaccine with 80% efficacy and 90% coverage could prevent 1 07 000 (UR, 20000–198000) stillbirths and infant deaths.ConclusionsOur conservative estimates suggest that GBS is a leading contributor to adverse maternal and newborn outcomes, with at least 4 09 000 (UR, 144000–573000) maternal/fetal/infant cases and 1 47 000 (UR, 47000–273000) stillbirths and infant deaths annually. An effective GBS vaccine could reduce disease in the mother, the fetus, and the infant.AcknowledgementAdditional authors include H Blencowe (1), S Cousens (1), CJ Baker, L Bartlett, C Cutland, MGGravett, PT Heath, M Ip, K Le Doare, SA Madhi, CE Rubens, SK Saha, SJ Schrag, A Sobanjo-ter Meulen, J Vekemans

BackgroundThe Baby Box (BB) comes with a firm waterproof mattress that provides a safe place for babies to sleep; and helps to prevent co-sleeping, which has been identified as a risk factor for SIDS [1]. An online educational package on safe sleeping (SS) is going to be an integral part of the intervention. Working in an area of deprivation and diversity, understanding our parents is vital in order to promote SS and the BB effectively.AimsTo assess; 1) Whether parents received SS advice antenatally2) Parental knowledge on SS practices3) Parental views on the BBMethodsWe used a questionnaire to explore parental knowledge and views on using the BB. Google translate was used to communicate with non-English speaking parents. SS advice was offered to all parents.Results30 parents, of 15 different ethnicities were assessed. Only 10 out of 30 women received SS advice during pregnancy, which is reflected in the parental SS assessment results in Table below.Abstract G137(P) Table 1SS-Practices%-Women-Correctly-Identified-SS-PracticesOn-back87In-Own-Cot90With-head-uncovered53Unsafe-Sleeping-Practices%-Women-Incorrectly-Identified-As-SS-PracticesOn-front0On-Side37Co-sleeping10Loose-Fitting-Bedding17On-Sofa310% of parents had not made baby sleeping arrangements. 27% of parents had heard of the BB and 47% of parents would use the BB after being shown it. Barriers to using the BB included concerns about hygiene, about other children being able to climb into the BB and concerns about design. Reasons for using the BB included the portability, proximity to parents and safety.ConclusionsProviding SS advice needs to improve and be available in several languages with the use of pictures to meet the needs of a diverse yet captive population; a need which is anticipated to be met by the launch of the online education package. The BB is now going to be promoted to parents at booking when sleep arrangements have not been made. Promoting the safety and portability aspects of the BB is key to increasing its use.