TNF and autoimmune disease: Anti-TNF-α) and immunomodulators, as monotherapy or in combination, are used increasingly to maintain disease remission1 2 and both types of drugs cross the human placenta.3–8 The use of these drugs during pregnancy is not associated with adverse pregnancy outcomes, such as preterm delivery, low birth weight or congenital abnormalities,9–15 however, the impact on the development of children’s immune system, growth and risk of autoimmune diseases and malignancies later in life is poorly studied.