APRICOT Study Assessment of Point-of-care Creatinine testing In Pregnancy: a prospective cohort study in Sierra Leone

Acute kidney injury in pregnancy (PrAKI) can lead to serious complications for mothers and babies, including long-term health problems and risks in future pregnancies. It is more common in low-income countries, where access to testing and treatment is limited. To our knowledge this is the largest study to date, involving 1,669 women at high risk of PrAKI at a maternity hospital in Sierra Leone. To diagnose PrAKI, we tested a marker of kidney function called creatinine using a simple finger-prick blood test, that gives results in 4 minutes without needing a laboratory. Our findings show that PrAKI is common and dangerous. One in four had tests which showed kidney injury and these women were more likely to experience severe pregnancy complications. Using point-of-care creatinine testing in pregnancy could help detect PrAKI earlier, guide treatment, and improve outcomes for mothers and babies, even in the most resource limited environments.