Several studies have shown that in pregnant women with GDM, placental tissues exhibit elevated expression of pro-inflammatory cytokines such as interleukin-6 (IL-6), TNF-\documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$\alpha$$\end{document}, and chemokines including CCL2(C-C motif chemokine ligand 21) and TLR4, which are associated with increased macrophage infiltration and systemic immune dysregulation30. Here, TLR4 is linked to gestational diabetes.