Moreover, down-regulation of both extrinsic and intrinsic apoptotic pathways is observed in placentas with GDM, which has been documented as reduced expression of both anti-apoptotic genes (including BCL2, BCL2L1, BCL2L2, MCL1, and XIAP) and pro-apoptotic proteins (including the Fas receptor, Fas ligand, caspase-3, and its poly-(ADP-ribose)-polymerase) [17]. This evidence concerns the gene MCL1 and gestational diabetes.