First-Trimester Zinc Supplementation Reduces Preeclampsia Incidence in Chronic Hypertensive Pregnancies: A Single-Center Retrospective Observational Study.

To evaluate whether first-trimester zinc status is associated with a reduced incidence of preeclampsia (PE) and improved maternal-neonatal outcomes in pregnant women with chronic hypertension. This retrospective observational study included 205 women with chronic hypertension who were stratified into two groups based on their first-trimester supplementation records: a zinc supplementation group (n = 104, receiving 20 mg/day from 12 weeks gestation) and a control group (n = 101, receiving no supplementation). Serum zinc levels, inflammatory markers (TNF-α, hs-CRP), and maternal-neonatal outcomes were assessed and compared between groups. Women in the zinc supplementation group exhibited significantly higher serum zinc levels at 34 weeks (11.64 ± 2.86 vs. 7.85 ± 2.84µmol/L; P < 0.01) and lower levels of TNF-α and hs-CRP (both P < 0.01) compared to the control group. The incidence of PE was significantly lower in the zinc supplementation group (21.15% vs. 38.61%; relative risk [RR] = 0.77, 95% CI [0.63, 0.95], P = 0.01). Furthermore, the zinc group had improved neonatal outcomes, including higher birth weight (2954.52 ± 399.29 vs. 2796.93 ± 474.75 g; P = 0.03), a reduced risk of low birth weight (RR = 0.49, P = 0.001), and higher Apgar scores (P = 0.005). First-trimester zinc supplementation is associated with a lower risk of PE and improved neonatal outcomes in women with chronic hypertension. This association may be mediated by anti-inflammatory mechanisms. These findings highlight the potential of zinc-oriented nutritional strategies and warrant further investigation in high-risk pregnancies.