FEATURES OF CLINICAL COURSE OF ASTHMA IN PREGNANT WOMEN DEPENDING ON THE LEVEL OF EXHALED NITROGEN OXIDE AND VITAMIN D IN THE ORGANISM
The aim of the study was to investigate the contents of exhaled nitrogen oxide and vitamin D level in the blood serum of patients with asthma in the dynamics of pregnancy and establish the extent of influence of their concentration on the clinical course of the disease and the state of health of posterity. 96 pregnant women with asthma were examined; among them there were 33 patients with controlled asthma, 39 with partially controlled one, and 24 with uncontrolled asthma. 47 patients had mild asthma, 43 patients had moderate asthma and 6 had severe asthma. The comparison group consisted of 26 pregnant women without bronchopulmonary pathology. Clinical and anamnestic data, results of lung function study were used; the level of exhaled nitrogen oxide and concentration of vitamin D in blood serum were determined in dynamics of pregnancy in patients depending on severity of the disease and level of monitoring. The state of health of newborns from pregnant women with asthma was assessed. It was found out that patients with severe asthma in comparison with mild and moderate ones had higher level of NOex during pregnancy: from 46.3±5.0 ppb in the 1st trimester till 59.0±3.2 ppb in the 3rd trimester (р<0.05). Average level of vitamin D in pregnant women with asthma was 23.26±1.5 ng/ml; in the control group it was 36.1±0.74, which indicates insufficient levels of vitamin D in patients with asthma during pregnancy. In pregnant patients with asthma NOex level and vitamin D contents correlated with the severity of the disease, the level of control of asthma and duration of gestation. At the stage of screening all pregnant women with vitamin D deficiency were registered to have intrauterine growth retardation, and while assessing the condition of the newborn by Apgar low rates were found in children from mothers with low vitamin D. The levels of NOex and vitamin D in pregnant woman can be used to determine the dynamics of the disease in the gestation period.