摘要N6-甲基腺嘌呤（N6-methyladenosine， m6A）是真核细胞中最丰富的RNA修饰，通过甲基转移酶样蛋白家族（methyltransferase-like， METTL）3-METTL14复合物动态调控基因表达。研究表明，m6A修饰在妊娠过程中发挥关键作用，其异常与多种妊娠并发症密切相关。METTL3-METTL14通过调控滋养层细胞功能、母胎界面免疫平衡及胚胎发育信号通路，参与子痫前期、妊娠期糖尿病和自然流产等疾病的发病机制。本综述系统总结了m6A修饰在妊娠生理和病理过程中的最新进展，重点探讨其对胎盘发育、母胎免疫调节等关键环节的调控作用，同时分析了m6A作为妊娠并发症诊断标记物的潜力，以及靶向调控m6A修饰的治疗策略。这些研究为妊娠相关疾病的精准诊疗提供了新思路。

abstractsN6-methyladenosine (m6A), the most abundant RNA modification in eukaryotic cells, dynamically regulates gene expression through the methyltransferase-like (METTL) 3-METTL14 complex. Emerging evidence indicates that m6A modifications play pivotal roles in pregnancy, with their dysregulation closely linked to gestational complications. The METTL3-METTL14 complex contributes to preeclampsia, gestational diabetes, and spontaneous abortion by modulating trophoblast function, maternal-fetal immune balance, and embryonic developmental signaling pathways. This review synthesizes recent advances in the role of m6A modifications in physiological and pathological pregnancy processes, focusing on their regulation of placental development and maternal-fetal immunomodulation. Additionally, we evaluate the diagnostic potential of m6A as a biomarker for gestational disorders and discuss therapeutic strategies targeting m6A modulation. These insights provide novel perspectives for the precision management of pregnancy-related diseases.