A successful pregnancy requires that the maternal immune system recognizes and tolerates the semi-allogeneic fetus without compromising the capability of protecting both mother and fetus from various pathogens. Decidual macrophages present unique phenotypes to play a key role in the establishment of the immunological aspects of maternal-fetal interaction. Dysfunction of decidual macrophages gives rise to pregnancy complications such as preeclampsia, recurrent spontaneous miscarriage, preterm labor and fetal growth restriction. Here, we reviewed the latest knowledge on the origin, differentiation, unique phenotype and function of macrophages in normal pregnancy and in pregnancy complications. We mainly focused on the significant roles of decidual macrophages in the process of extravillous trophoblast invasion, spiral arterial remodeling, decidual stromal cells cultivation and immune tolerance maintenance in normal pregnancy, and their pathological roles in pregnancy-related complications, offering more integrated information in maternal-fetal immunity.

成功怀孕需要母体免疫系统识别并耐受半同种异体胎儿，同时又不损害保护母体和胎儿免受各种病原体侵害的能力。蜕膜巨噬细胞呈现出独特的表型，在建立母胎相互作用的免疫学方面发挥关键作用。蜕膜巨噬细胞的功能障碍会引起妊娠并发症，例如先兆子痫、复发性自然流产、早产和胎儿生长受限。在这里，我们回顾了关于巨噬细胞在正常妊娠和妊娠并发症中的起源、分化、独特的表型和功能的最新知识。我们主要关注蜕膜巨噬细胞在绒毛外滋养细胞侵袭、螺旋动脉重塑、