Assessing a Tool for Self-Monitoring Hydration Using Urine Color in Pregnant and Breastfeeding Women: A Cross-Sectional, Online Survey.

Background: Pregnant and breastfeeding women experience great changes in their total body water content and water dynamics. To support the accretion of total body water during pregnancy and compensate for the water lost through breast milk during breastfeeding, increased adequate intakes (AI) for total water have been established by various health authorities. Despite this widespread advice, several studies suggest that pregnant and breastfeeding women do not meet the AI for total water, suggesting the need to raise women's awareness on the importance of adequate water intake, particularly during pregnancy and breastfeeding, as well as to provide them with a simple means of monitoring their hydration on a day-to-day basis. A urine color (UC) scale recently has been validated for hydration monitoring in pregnant and breastfeeding women.

Summary: We sought to develop a version of a tool based on the UC scale, using only images or illustrations, which could be understood by users of various nationalities and spoken languages. Pregnant and breastfeeding women (n = 1,275) from Brazil, Mexico, and Poland were shown 3 versions of the tool. Understanding, appreciation, simplicity and intent to use were evaluated using a questionnaire consisting of 26 items. Key Messages: Among the 3 versions tested, one tool emerged as the most highly understood (88% spontaneous understanding) and was highly appreciated by users (mean [SD]: 8.40 [2.20] out of 10). There were no differences between countries. Furthermore, 83% reported being very likely to use the tool daily. These results suggest that a simple tool based on the UC scale will help pregnant and breastfeeding women meet the AI for total water.