King's College London

The APRICOTS study (Acceptability of Point of Care Testing in Pregnancy) is a feasibility cohort study investigating the use of point-of-care testing (PoCT) for the early identification of pregnancy-associated acute kidney injury (Pr-AKI). Pr-AKI is a potentially serious condition with significant risks for both maternal and fetal health, including higher rates of maternal mortality, stillbirth, and neonatal complications. Despite its importance, there is limited research on early detection and prevention strategies for Pr-AKI in pregnancy.

This study aims to assess the feasibility and acceptability of PoCT for pregnant women and healthcare professionals. It explores the utility of novel biomarkers, such as urinary TIMP-2 x IGFBP-7 and serial capillary creatinine measurements, in predicting Pr-AKI. The study also evaluates intrapartum and postpartum variations in creatinine levels to better understand physiological changes during pregnancy.

APRICOTS follows a prospective longitudinal design and involves recruiting pregnant women across four groups: those at low risk, those who develop new risk factors during pregnancy, those with known risk factors, and healthcare professionals. Participants will undergo serial PoCT creatinine testing, fluid status assessments, and biomarker analysis during pregnancy and postpartum. Questionnaires and interviews will gather qualitative data on the acceptability of PoCT from both women and healthcare professionals.

The study's findings will provide critical insights into the feasibility of integrating PoCT into routine obstetric care and its potential to improve the early detection and management of Pr-AKI. By focusing on accessible, non-invasive testing methods, APRICOTS aims to support better maternal and neonatal outcomes, reduce the burden of pregnancy complications, and inform future strategies for scaling up Pr-AKI screening.

Ultimately, APRICOTS seeks to pave the way for larger-scale studies and evidence-based interventions to address the unmet need for improved renal care in pregnancy.