IKK-NF-κB axis is a context-dependent regulator of autophagy[52] ROS may also promote autophagy, and the imbalance of cell autophagy might also contribute to the observed placental phenotypes directly or indirectly.[51, 53, 54] So there may be a closed loop in the GDM placenta, high glucose stimulates TLR4s pathway, and there is an imbalance between the internal and external environment of placental villus trophoblast cells. The gene discussed is NFKB1; the disease is gestational diabetes.