BackgroundThis study assessed serum, dietary zinc levels, and other risk factors during the third trimester among pregnant women with and without pregnancy-induced hypertension (PIH).MethodsThis case-control study was conducted in 2022, in the three main Obstetrics and Gynecology departments in Gaza Strip, Palestine. One hundred sixty pregnant women, during the third trimester, aged ≥20 years, were selected using a convenient sampling method. Data were obtained using an interview-based questionnaire, food frequency questionnaire, anthropometric measures, and biochemical tests. Statistical analysis was performed using SPSS version 24.ResultsThe participants’ mean age was 30.7 ± 5.6 years. A total of 47 (58.8%) of cases and 6 (7.5%) of controls were insufficiently active; and the mean of blood pressure (mmHg) was 133.3 ± 11.9/85.11 ± 10.0 for cases and 112.8 ± 9.5/68.02 ± 7.2 for controls with significant differences between the two groups (P= <0.005). The mean serum zinc level (μg/dl) was 67.15 ± 16.5 for cases and 68.45 ± 18.0 for controls without significant differences between the two groups (P= 0.636). For newborns, the mean birth weight (g) was 2,904.6 ± 486 for cases, and 3,128.3 ± 501 for controls, and the mean Apgar score was 8.03 ± 0.62 for cases and 8.30 ± 1.17 for controls, with significant differences between the two groups (P= <0.005). Furthermore, 43 (53.8%) of cases have family history of hypertension; 5 (6.2%) were primiparous; 19 (23.8%) have previous caesarian section; 33 (41.2%) have history of preeclampsia; and 62 (77.5%) have edema, with significant differences between the two groups (P= <0.005). Additionally, the total zinc dietary daily intake (mg/day) was 4.15 ± 2.10 for cases and 4.88 ± 3.02 for controls, with significant differences between the two groups (P= 0.041). After adjustment for confounding variables, participants in the case group have higher odds of having low total zinc dietary intake compared to those in the control group [OR = 1.185, 95% CI = (1.016–1.382),P= 0.030].ConclusionThe current study showed the main risk factors of PIH among pregnant women in the Gaza Strip, Palestine. Furthermore, low maternal dietary zinc intake was associated with a high level of PIH. Moreover, having PIH could increase the risk of low birth weight and low Apgar scores. Therefore, reducing the main risk factors of PIH could reduce the adverse effect on both mother and birth outcomes.