Objective To investigate the effect of hypertensive disorder of pregnancy (HDP) on the structure of intestinal flora in offspring. Methods A total of 30 HDP pregnant women were selected as the HDP group, and 30 normal pregnant women as the control group. The first⁃time meconium after the birth of offspring was collected to perform 16S rRNA sequencing. The difference of intestinal flora structure of offspring in both groups was analyzed, and the correlation of blood lipid indices of pregnant women with intestinal flora in offspring was also analyzed. Results The HDP group yielded lower Chao1 index of offspring as compared with the control group (P<0.05). At the phylum level, compared with the control group, the HDP group exhibited lower relative abundance of Actinobacteria and Proteobacteria, higher relative abundance of Firmicutes and Bacteroidetes, and a higher Firmicutes⁃to⁃Bacteroidetes ratio in intestinal flora. At the genus level, the HDP group presented higher relative abundance of pathogenic bacteria such as Enterococcus, Staphylococcus, Bacteroides, and Klebsiella in intestinal flora of offspring as compared with the control group, while the HDP group interpreted lower relative abundance of beneficial bacteria such as Roseburia and Bifidobacterium as compared with the control group. From order level to genus level, a total of 10 bacterial taxa revealed a significant difference in relative abundance between the two groups. The HDL⁃C level of pregnant women negatively correlated with the relative abundance of intestinal Prevotellaceae_NK3B31_ group of offspring, and the cholesterol level of pregnant women negatively correlated with the relative abundance of intestinal Roseburia of offspring (P<0.05). Conclusion HDP can lead to the destruction of intestinal microecological balance in offspring, and the imbalance of intestinal flora may be one of the important reasons for the occurrence of various diseases in offspring with HDP. Maternal blood lipid metabolism is related to intestinal flora in offspring.

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