The authors reported that the target genes of these miRNAs were involved in the epidermal growth factor receptor (EGFR)/PI3K/Akt pathway in placental and fetal development, and they presented a model proposing that enhanced EGFR signaling exists in tissues under GDM conditions, contributing to enhanced fetal and placental growth, resulting in macrosomia, since activation of the PI3K/Akt pathway enhances cell proliferation, survival, and growth (among other functions) [88]. The gene discussed is AKT1; the disease is Large for gestational age.