Noticing protein in your urine during pregnancy can be concerning. You might wonder if those trace amounts appearing on test strips at your prenatal appointments are normal or something that requires attention. The good news is that understanding protein levels in urine during pregnancy is straightforward once you know what's typical and when to seek help.

In this comprehensive guide, you'll learn about normal protein ranges during pregnancy, what causes elevated levels, and when you should talk to your healthcare provider about your results.

Normal protein levels in urine during pregnancy

During pregnancy, your kidneys work harder to filter your blood, which can sometimes result in small amounts of protein appearing in your urine. This is completely normal in many cases.

What's considered normal:

• Non-pregnant adults: Less than 150 mg of protein in 24 hours (less than 30 mg/dL on a random sample)

• During pregnancy: Up to 300 mg in 24 hours can be normal

• Dipstick test results: Negative to trace amounts (0 to 1+)

According to a study published in the American Journal of Obstetrics and Gynecology, up to 20% of healthy pregnant women may exhibit transient, low-level proteinuria due to increased renal plasma flow and glomerular filtration during pregnancy, particularly in the third trimester.

How protein in urine is measured during pregnancy

Your healthcare provider will typically check your urine protein levels at every prenatal visit using one of several methods:

Dipstick urine test

This quick test involves dipping a chemical strip into your urine sample. Results are usually reported as:

• Negative (normal)

• Trace (barely detectable)

• 1+ (30 mg/dL)

• 2+ (100 mg/dL)

• 3+ (300 mg/dL)

• 4+ (1000+ mg/dL)

Negative to trace amounts are typically considered normal during pregnancy.

Protein-to-creatinine ratio

This more precise test measures the ratio of protein to creatinine in your urine.

• Normal ratio during pregnancy: Less than 0.3

• Ratios above 0.3 may indicate kidney issues or preeclampsia

To ensure accuracy, your doctor may request a 24-hour urine collection, which offers a complete picture of your protein excretion

24-hour urine collection

If your doctor suspects an issue, they might request this comprehensive test:

• You collect all urine over a 24-hour period

• Normal result: Less than 300 mg of protein in 24 hours

• Results over 300 mg may indicate a problem requiring further evaluation

Some women choose to supplement clinic visits with at-home urine protein test strips for added peace of mind between appointments.

When protein levels rise: Understanding the causes

Several factors can cause protein levels in your urine to rise during pregnancy. Some are temporary and harmless, while others may signal a condition requiring medical attention.

Common benign causes

• Dehydration: When you're not drinking enough water, your urine becomes more concentrated

• Strenuous exercise: Intense physical activity can temporarily increase protein levels

• Urinary tract infections: These common pregnancy complications can cause protein to appear

• Fever or illness: Being sick can temporarily elevate protein levels

• Prolonged standing: Standing for long periods can affect kidney filtration

Common causes of temporary proteinuria include urinary tract infections, dehydration, and physical stress.

Medical conditions associated with elevated protein

• Preeclampsia: A serious pregnancy complication characterized by high blood pressure and protein in urine (typically over 300 mg in 24 hours)

• Gestational hypertension: High blood pressure that develops after 20 weeks

• Kidney infections: More severe than UTIs and can cause significant protein spillage

• Chronic kidney disease: Pre-existing kidney conditions that may worsen during pregnancy

• Diabetes: Both pre-existing and gestational diabetes can affect kidney function

According to a study published in the American Journal of Obstetrics and Gynecology, the incidence of preeclampsia among pregnant women is approximately 2.2%. This condition is characterized by high blood pressure and proteinuria, and early detection through regular urine testing is crucial for effective management."

What is preeclampsia and why does it cause protein in urine?

Preeclampsia is a serious pregnancy complication that typically develops after 20 weeks of pregnancy. It's characterized by:

• High blood pressure (140/90 mmHg or higher)

• Significant protein in urine (proteinuria)

• Sometimes swelling in the face and hands

When you have preeclampsia, changes in your blood vessels damage the filtering system in your kidneys, allowing proteins that would normally stay in your bloodstream to leak into your urine.

Risk factors for preeclampsia

You may have a higher risk of developing preeclampsia if you:

• Are pregnant for the first time

• Have a family history of preeclampsia

• Are carrying multiples (twins, triplets)

• Are under 18 or over 40 years old

• Have pre-existing conditions like high blood pressure, diabetes, or kidney disease

• Had preeclampsia in a previous pregnancy

• Have a BMI over 30

• Had in vitro fertilization

Timeline: When protein typically appears in pregnancy

Understanding when protein might show up in your urine can help you better understand your test results:

First trimester (weeks 1-12)

• Trace amounts of protein may appear but are usually not concerning

• Persistent protein should be evaluated, as it could indicate pre-existing kidney issues

Second trimester (weeks 13-26)

• Small amounts remain generally normal

• After week 20, rising protein levels warrant closer monitoring for preeclampsia

Third trimester (weeks 27-40)

• Slight increases may occur as pregnancy progresses

• Sudden or significant increases, especially with high blood pressure, require immediate medical attention

Persistent proteinuria in early pregnancy, especially when accompanied by discolored urine, may signal a problem—urine color can offer an early clue.

What happens when protein is detected in your urine

If your healthcare provider detects protein in your urine during a routine screening, don't panic. Here's what typically happens next:

For trace amounts (dipstick reading of trace or 1+):

• Your provider will note the finding

• They'll check your blood pressure for any elevation

• You'll likely be advised to stay well-hydrated

• A follow-up test at your next appointment will monitor any changes

For moderate amounts (dipstick reading of 2+):

• Additional testing may be ordered, such as a protein-to-creatinine ratio

• Your provider will check for other symptoms of preeclampsia

• More frequent monitoring may be recommended

• You might be asked to collect a 24-hour urine sample

For high amounts (dipstick reading of 3+ or 4+):

• Immediate evaluation for preeclampsia

• Blood tests to check kidney and liver function

• Possible hospital admission for monitoring

• Treatment decisions based on gestational age and severity

A routine urinalysis can detect protein, glucose, white blood cells, and other signs of infection or kidney dysfunction.

How to reduce protein in urine during pregnancy

If you have mild to moderate proteinuria without preeclampsia, these strategies may help reduce protein levels:

Stay well-hydrated

• Aim for 8-10 glasses of water daily

• Clear or light yellow urine indicates good hydration

• Avoid excessive caffeine, which can increase dehydration

Balanced diet for kidney health

• Focus on kidney-friendly foods like berries, leafy greens, and fish high in omega-3s

• Limit processed foods high in sodium

• Consider reducing protein intake if recommended by your doctor

Managing blood pressure naturally

• Regular, moderate exercise (with your doctor's approval)

• Stress reduction techniques like prenatal yoga or meditation

• Getting adequate sleep (7-9 hours nightly)

When to avoid exercise

If you've been diagnosed with preeclampsia or severe proteinuria, you should follow your doctor's guidance regarding activity levels. In some cases, bed rest or limited activity may be recommended.

Monitoring protein at home

While professional medical monitoring is essential, some women find additional peace of mind with at-home options:

At-home urine test strips

• Available over-the-counter at pharmacies

• Can detect the presence of protein

• Should not replace professional medical testing

• Results should always be discussed with your healthcare provider

If your urine pH is also elevated, it could point toward other conditions like renal tubular acidosis.

Blood pressure monitoring

• At-home blood pressure cuffs can help track this important vital sign

• Record readings at the same time each day

• Report concerning patterns to your doctor

Symptom tracking

Keep a log of symptoms that might indicate worsening proteinuria or preeclampsia:

• Swelling in face or hands

• Headaches that don't respond to acetaminophen

• Visual disturbances like blurry vision or seeing spots

• Pain in the upper right abdomen

• Sudden weight gain (more than 2 pounds in a week)

When to call your doctor immediately

Some symptoms should never be ignored during pregnancy, especially if you've had protein in your urine. Call your healthcare provider right away if you experience:

• Severe headache that doesn't improve with acetaminophen

• Vision changes (blurry vision, seeing spots or flashing lights)

• Upper abdominal pain, especially on the right side under your ribs

• Sudden swelling in your face or hands

• Difficulty breathing or shortness of breath

• Decreased fetal movement

• Severe nausea and vomiting

These could be signs of worsening preeclampsia, which requires immediate medical attention.

Treatment options for elevated protein in pregnancy

Treatment depends entirely on the cause and severity of proteinuria:

For mild proteinuria without high blood pressure

• Regular monitoring at prenatal visits

• No specific treatment usually required

• Focus on staying well-hydrated

For urinary tract infections

• Pregnancy-safe antibiotics

• Increased fluid intake

• Follow-up testing to ensure resolution

For preeclampsia

Treatment varies based on severity and how far along you are in pregnancy:

Mild preeclampsia:

• More frequent prenatal visits

• Blood and urine tests

• Possible medication for blood pressure

• Careful monitoring until delivery

Severe preeclampsia:

• Hospitalization

• Medications to prevent seizures (typically magnesium sulfate)

• Blood pressure medications

• Steroids to help mature baby's lungs if early delivery is needed

• Delivery may be recommended, depending on gestational age

According to a 2024 study published in The New England Journal of Medicine, early intervention with low-dose calcium supplementation during pregnancy significantly reduces the risk of preeclampsia and preterm birth. This underscores the importance of regular prenatal care and urine testing for early detection and management of preeclampsia.

Long-term outlook

The good news is that for most women, protein in urine during pregnancy resolves after delivery.

For pregnancy-specific conditions like preeclampsia:

• Protein levels typically return to normal within 12 weeks after delivery

• Blood pressure usually normalizes within days to weeks

• Regular follow-up is important to ensure complete resolution

For pre-existing kidney conditions:

• Long-term monitoring may be needed

• Treatment plans will be adjusted post-pregnancy

• Future pregnancies may require specialized care

According to a 2024 study published in the Journal of the American Society of Nephrology, women who experienced preeclampsia during pregnancy have a significantly higher risk of developing chronic kidney disease and cardiovascular complications later in life. This underscores the importance of regular postpartum follow-up care to monitor and manage potential long-term health risks.

Prevention strategies for future pregnancies

If you've experienced significant proteinuria or preeclampsia in a previous pregnancy, these strategies may help reduce your risk in future pregnancies:

• Low-dose aspirin: Your doctor may recommend daily low-dose aspirin starting around 12 weeks

• Calcium supplements: Particularly if your dietary calcium intake is low

• Maintain a healthy weight: Before and during pregnancy

• Manage chronic conditions: Keeping diabetes and hypertension well-controlled before conception

• Early and regular prenatal care: Allowing for close monitoring throughout pregnancy

For a more complete understanding of how your kidneys work during pregnancy, read this detailed guide on how to protect your kidneys and prevent long-term damage

Conclusion

Every pregnancy is unique, and navigating unexpected findings, such as protein in the urine, can be unsettling. The reassuring news is that many of these changes are manageable, especially when detected early. Regular prenatal visits, clear communication with your care team, and staying informed are key to supporting a healthy pregnancy.

While most cases of pregnancy-related proteinuria resolve after delivery, monitoring between appointments can offer added peace of mind. Ribbon Checkup provides a simple, at-home urine test to help track protein levels and support early awareness.

To learn more or order your test, visit RibbonCheckup.com.

 

Written by Abel Tamirat, MD
Dr. Abel Tamirat is a licensed General Practitioner and ECFMG-certified international medical graduate with over three years of experience supporting U.S.-based telehealth and primary care practices. As a freelance medical writer and Virtual Clinical Support Specialist, he blends frontline clinical expertise with a passion for health technology and evidence-based content. He is also a contributor to Continuing Medical Education (CME) programs.

Related resources

• Collecting a 24-hour urine sample provides the most accurate measurement of total protein excretion during pregnancy.

• At-home urine protein test strips can be helpful for tracking trends but should always be followed up by a healthcare provider.

• Understanding kidney function is crucial if you've had high protein levels in your urine during pregnancy.

• A kidney-friendly diet may reduce strain on your renal system and support better outcomes during pregnancy.

References

• Preeclampsia and preterm birth risk may be reduced by calcium dose lower than current WHO standard | Harvard T.H. Chan School of Public Health. (2024, January 11). Retrieved May 11, 2025, from Harvard T.H. Chan School of Public Health website: https://hsph.harvard.edu/news/preeclampsia-and-preterm-birth-risk-may-be-reduced-by-calcium-dose-lower-than-current-who-standard/ 

• Preeclampsia-Preeclampsia - Symptoms & causes - Mayo Clinic. (2022). Retrieved May 11, 2025, from Mayo Clinic website: https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745 

• Srialluri, N., Surapaneni, A., Chang, A., Mackeen, A. D., Paglia, M. J., & Grams, M. E. (2023). Preeclampsia and Long-term Kidney Outcomes: An Observational Cohort Study. American Journal of Kidney Diseases, 82(6), 698–705. https://doi.org/10.1053/j.ajkd.2023.04.010 

• Villar, J., Carroli, G., Wojdyla, D., Abalos, E., Giordano, D., Ba’aqeel, H., … Kramer, M. (2006). Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions? American Journal of Obstetrics and Gynecology, 194(4), 921–931. https://doi.org/10.1016/j.ajog.2005.10.813