Changes in Urine Color During Pregnancy:When to Worry

A change in color of urine, during pregnancy or otherwise, in most of the cases is normal, but in some cases it indicates an underlying cause. 
The two parameters to focus on when assessing your urine, is the color and the output. 

• Urine color is a practical indicator of the urine concentration suggesting the adequacy of fluid intake or loss of metabolic compounds from body.
• Urine output, specifically, is a way to assess the hydration levels of an individual.

In human body both water intake and water losses are regulated to maintain a balance. 

Importance of Hydration in Pregnancy

• About 60% of human body is water. It plays a pivotal role in metabolism of cell, transport of nutrients and wastes throughout the body. 
• During pregnancy, the volume of fluid in blood vessels (plasma) expands to meet the increasing demands of nourishing the baby. 
• On an average a women gains about 11 Kg body weight during pregnancy. Major contributor for this gain is the water retention (which is about 7-8L).  
• The water requirements keep increasing from conception to lactation. 
• Benefits to mother:
  • Healthy rise in total body volume
  • Compensates for the excess water loss due to vomiting, sweating, etc. 
  • Maintains a balance in hormones regulating fluid-electrolyte balance of body
  • Temperature regulation of body 
• Benefits to the baby:
  • Proper tissue development and growth
  • Shock absorber
  • Maintains amniotic fluid levels (cushioning effect)

Although the individual water needs vary greatly depending on personal intake and loss it is crucial to maintain adequate levels to compensate for daily losses and maintain a healthy urine output 

Factors contributing to changed urine color

• Dehydration
• Changes in diet
• Certain medications, vitamin supplements
• Urinary tract infections (UTI)
• Urinary bladder infections
• Kidney diseases
• Diabetes

Urine color chart

The following colors indicate possible signs: 

• Clear: Drinking lot of water
• Pale or transparent: Drinking sufficient water
• Dark yellow: Not drinking enough water
• Orange: Severe dehydration. Vitamin pills and certain other medications can be a cause.
• Dark orange or brown: Severe dehydration or body not producing enough. Can also indicate a liver problem. 
• Dark brown or black: Indicates underlying medical condition
• Pink or red: Indicates blood in urine. Can be due to certain medications and foods such as excess beetroot intake. 
• Blue or green: May indicate a urinary tract infection. Can also occur due to medications
• Cloudy: A sign of urinary tract infection
• White or milky: Underlying medical condition. 

What color is normal urine?

• Urine naturally has a light yellow or yellow to transparent color due to the presence of pigment Urobilin (Also called urochrome) . 
• This pigment is produced due to breakdown of hemoglobin present in red blood cells. 
• With adequate hydration, this pigment is diluted and the urine looks light yellow, close to clear color. 
• Change in water levels, concentrate the urine and imparts it a dark yellow to orange color. 

What color is Pregnancy urine?

• In a pregnant women the color can normally change from light yellow to dark yellow . In some cases, orange yellow too.

Why does urine color change in pregnancy?

• The kidney function, structure and amount of fluid filtered is changed throughout pregnancy to compensate for the increase in body fluid volume, nutrients, waste materials, altered hormones. Consequently altered hydration levels is a common cause of color change.
• Intake of supplements, routine medications for pregnancy can alter the color of the urine. 
• A women suffering with diabetes or on diuretics ( water pills) may find themselves urinating frequently. This affects the water intake, and thus the color.  
• Urine with unusual odour or smell can be an indicator of diabetes or infections.
• Presence of high proteins in urine indicate kidney diseases or urinary Tract Infections (UTI). 
• Presence of red cells indicate UTI. 
• High sugar levels can indicate new onset diabetes or inadequate control of pre-existing diabetes. 

When should you see a doctor? 

• A little change in the color of urine is normal during pregnancy. Hence there is no need to panic. 
• The first step is to hydrate yourself enough. 
• Despite this if the color does not change or if the body shows unusual signs you should consult a doctor near you. 
• It is important to evaluate the possible causes such as decreased water intake, starting a new medication, burning sensation in the urine, rise in body temperature, bad smelling urine. 
• Your doctor will run some routine tests to identify the cause and put you on medications accordingly. 
• Consequently, getting routine urine examinations done during pregnancy is crucial to check for any abnormal increase in proteins/ sugars/ infections.  

Consult a gynecologist near you to forgo any apprehensions. 

References: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290087/ 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117802/#:~:text=Recent%20findings,pressure%20and%20increased%20renal%20size. 
https://pubmed.ncbi.nlm.nih.gov/1124165/ 
https://pubmed.ncbi.nlm.nih.gov/19724292/