The syncytiotrophoblast (STB) is a multinucleated single cell that plays a critical role in regulating functions of the placenta during pregnancy. Maintaining the STB layer relies on the ongoing fusion of mononuclear cytotrophoblasts throughout pregnancy, and errors in this process could lead to serious pregnancy complications such as preeclampsia. While various biochemical factors are known to drive fusion, the role of biophysical cues remains undefined. By altering the substrate mechanics using polyacrylamide hydrogel, we first demonstrated that trophoblast fusion is mechanically sensitive and can be directly modulated by endogenous tissue stiffness. Specifically, fusion was significantly enhanced on substrate with stiffness matching healthy in vivo placental mechanics, compared to preeclamptic tissue stiffness. To further investigate the role of endogenous mechanical stress in this fusion process, we micropatterned a model placental cell line in geometrically confined wells and analyzed fusion efficiency and microtissue function. We showed that if cell-generated mechanical stresses are sufficiently high, they suppress cell fusion, and cause hypersecretion of human chorionic gonadotropin (hCG), findings that match clinical observations of preeclamptic disease. Our results demonstrate a previously unknown role of mechanical cues in maintaining and regulating the formation and function of the STB during pregnancy