子宫腺肌症是子宫内膜腺体和间质侵入子宫肌层的良性病变，其通过破坏子宫内膜-肌层交界区完整性，诱发慢性炎症和纤维化改变，对胚胎着床、胎盘形成及子宫收缩功能产生多维度影响，不仅影响生育能力，还显著增加妊娠全周期不良影响和结局的风险。妊娠早期，腺肌症可降低子宫内膜容受性并扰乱免疫微环境，增加流产风险。妊娠中晚期，因子宫结构异常和炎症介质释放，早产、胎盘位置异常及妊娠期高血压疾病发生率明显升高，尤以弥漫性腺肌症更为突出。分娩及产后阶段，子宫肌层收缩功能受损和胎盘并发症进一步增加产后出血和胎儿不良结局风险。本文系统梳理子宫腺肌症与多种不良结局的关联及可能的病理生理机制，强调应将其视为妊娠高危因素，建立分级风险评估体系，实施全孕期动态监测与个体化管理，以改善母婴结局。

Adenomyosis is a benign condition characterized by the presence of endometrial glands and stroma with the myometrium.It not only impairs fertility but also significantly increases the risk of adverse pregnancy outcomes. By disrupting the integrity of the endometrial-myometrial junction and inducing chronic inflammation and fibrotic remodeling, adenomyosis exerts multidimensional effects on embryo implantation, placental development, and uterine contractile function. In early pregnancy, adenomyosis may impair endometrial receptivity and alter the local immune microenvironment, thereby significantly increasing the risk of pregnancy loss. During the second and third trimesters, uterine structural abnormalities and sustained inflammatory activation contribute to higher rates of preterm birth, placental abnormalities and hypertensive disorders of pregnancy, particularly in women with diffuse adenomyosis. During labor and the postpartum period, impaired myometrial contractility and placental complications further increase the risks of postpartum hemorrhage and adverse neonatal outcomes. This review systematically summarizes the associations between adenomyosis and adverse pregnancy outcomes and highlights the need to recognize adenomyosis as a high-risk pregnancy condition, which requires stratified risk assessment systems, dynamic monitoring and individualized management to improve maternal and neonatal outcomes.