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Ketones In Urine During Pregnancy: Causes, At-Home Test And Prevention

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When the body burns fat instead of glucose to produce energy, it produces a by-product called ketones. These ketones first appear in the blood and then in urine, a condition that’s also known as ketonuria (1).

During pregnancy, hormonal changes affect your body’s resistance to insulin, which plays a key role in glucose metabolism (2). This prevents the body cells from utilizing the glucose in blood sugar to produce energy. This, in turn, causes the cells to burn fats, thus producing ketones. But how would you know if there are ketones in urine, and whether it is a concern?

Read this MomJunction post for more details on ketones in urine during pregnancy, and to know how to maintain the optimum level of ketones in the urine.

Why Do Ketones Occur In Urine During Pregnancy?

Ketones may develop in the urine due to various reasons.  Although ketones appear in trace amounts throughout the pregnancy, excess ketones in urine for a considerable time could be an indication of gestational diabetes. If diagnosed early, the condition can be managed to ensure that you and your baby are both healthy.

Are Ketones In Urine Normal During Pregnancy?

Studies suggest that ketonuria is a common finding during pregnancy, possibly due to fasting or starvation, or vomiting over a long period (3). It is also reported that the appearance of ketones in urine was found throughout the pregnancy. So, if you find traces of ketones on and off during pregnancy, then it might not be linked to gestational diabetes.

However, this study also states that gestational diabetes is a possibility for a woman who showed clinical indications of pre-diabetes, or is showing signs of gestational diabetes. (1).

Your doctor is the best person to understand and interpret whether the ketones in your urine are indicating an adverse maternal condition, because, if the level of ketones goes up, then it may lead to diabetic ketoacidosis (DKA), a complication in diabetic pregnancies, which can cause fetal loss (3), (4).

Ketones can develop in the urine due to many reasons. Find out what they are next.

[ Read: Protein In Urine During Pregnancy ]

What Causes Ketones In Urine During Pregnancy?

During pregnancy, ketones can develop in urine if you (5):

  • Did not eat properly on the previous day
  • Missed your bedtime snack
  • Are on a low-carbohydrate diet
  • Are fasting during pregnancy
  • Have extreme morning sickness and diarrhea that leaves you dehydrated
  • Have any illness or infection
  • Did strenuous exercise on the previous day
  • Have gestational diabetes

It is important to know if the ketones in the urine pose any harm to the fetus. The section below talks about it.

Can Ketones Harm Your Baby?

Yes, they can, but only when your test results show abnormal ranges consistently. Studies show that ketones can easily cross the placenta and affect the fetal central nervous system. It showed embryo growth abnormalities, reduced volume, and distortion of the internal organs.

The studies have also shown a reduction of the cerebral cortex volume, corpus callosum, hippocampus, larynx, lateral brain ventricles, and thymus. However, the studies on the influence that ketones have on fetal development are limited (5).

In any case, you can test for ketones in urine at home and track the ketone level on an everyday basis.

Lab Test To Detect Ketones In Urine During Pregnancy

As high levels of ketones in urine might indicate an underlying clinical cause, you doctor might recommend a clinical diagnosis if they notice some of the below symptoms.

  • High blood glucose levels
  • Unusual thirst
  • Fatigue
  • Frequent vaginal, and bladder infections.

Lab tests for ketones in urine include urine-based dipstick test and blood tests (6).

How To Test For Ketones In Urine At Home?

You can also monitor the ketones in your urine using the dipstick test available at various pharmacies. Use it on the first urine of the day for the most accurate result. Ideally, the reading should be negative to trace (5).

You can take the test at home using the kit. First, take the urine sample in a clean container and dip the strip into the sample. Take it out and leave it aside for a few minutes. When the color of the strip pad changes,  compare it to the color chart mentioned on the kit bottle (5). If the ketone level in the urine is moderate or large, then, seek your doctor’s advice.

The ketone urine test is used to detect an already existing condition of ketonuria. Your doctor might prescribe blood monitoring to determine if you are having gestational diabetes (6). If your doctor finds out that you have gestational diabetes, then they would recommend diet and lifestyle changes to keep the blood glucose levels normal throughout the pregnancy.

The section below throws light on some preventive measures to control the ketone levels in urine during pregnancy.

How To Treat Ketonuria?

Based on the test results of the diagnostic tests, your doctor might prescribe the following treatment options.

  • If you are showing trace amounts of ketones and if they are due to vomiting or changes in diet, then it would resolve on its own.
  • But if your blood glucose levels indicate gestational diabetes, then your doctor might prescribe insulin, or dietary changes.
  • If the ketonuria is due to infection, then your doctor might prescribe medications, which are safe during pregnancy, to treat the infections.

How Can You Prevent Ketones In Urine?

Here are a few simple steps to keep your ketones at a healthy level (5):

  • Never skip meals
  • Eat three snacks and three meals every day
  • Include protein in your diet
  • Do not cut down on carbohydrates during pregnancy
  • exercise and stay active to reduce the risk of gestational diabetes

If ketones are present in trace amounts, it can be rectified by changing your diet and lifestyle a little. However, early medical attention becomes necessary in the case of higher ketone levels in the urine. This also helps to lower the chances of any pregnancy complications affecting you and your baby.

[ Read: What Causes Gestational Diabetes ]

Were you diagnosed with high ketones in urine during pregnancy? Share your experience in the comment section below.

References:

1. Helen L Robinson, et al.; Prevalence of maternal urinary ketones in pregnancy in overweight and obese women; The Royal Society of Medicine Journals
2. Symptoms & Causes of Gestational Diabetes; National Institute of Diabetes and Digestive and Kidney Diseases
3. Ketones in Urine; Medline Plus; US National Library of Medicine
4. Learning about ketones; Allina Health’s Patient Education Department (2014)
5. Agata Bronisz, et al.; Pregnancy Ketonemia and Development of the Fetal Central Nervous System; NCBI (2018)
6. Urine-based Ketone Testing in Pregnancy Complicated by Diabetes; Health Technology Inquiry Service

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