Importance: Congenital Zika syndrome virus infection is said to interfere in children's development. Objective: evaluate gross motor trajectories and the frequency of cerebral palsy in children with congenital Zika syndrome. Design: Cohort study applying the Alberta Infant Motor Scale (AIMS) and the Bayley III Scales in infants from 6 to 18 months of age. Setting: The SARAH network, Rio de Janeiro. Participants: Thirty-nine infants whose diagnoses were established through clinical history, serology tests, and neuroimaging findings. Main outcomes and measures: Congenital Zika syndrome is associated with severe motor delays and is a risk factor to the diagnosis of cerebral palsy. Results: The Alberta Infant Motor Scale mean raw score at 6 months was 9.74 (SD 4.80) or equivalent to 2 to 3 months of motor developmental age. At the age of 12 months, 14.13 (SD 11.90), corresponding to 3 to 4 months of motor development age; the Bayley III Scales results correlated to the Alberta Infant Motor Scale (P < .001) at this age. At 18 months, 15.77 (SD 13.80) or a motor development equivalent to 4 to 5 months of age. Thirty-five of 39 children (89.7%) met criteria for the diagnosis of cerebral palsy. Conclusions and relevance: Gross motor development marginally progresses from 6 to 18 months of age. These individuals also displayed a high frequency of cerebral palsy.

Introduction: Cerebral palsy is the most common physical disability of childhood. Respiratory problems are the main causes of morbidity and mortality in cerebral palsy. Methods: The study is characterized by a scoping review. The search for articles was carried out in August 2021 in the PubMed, Medline, SciELO, LILACs and Google Schoolar databases, with the keywords "cerebral palsy” and "respiratory". Results: Overall, 1037 articles were found, 10 duplicates were removed and 167 were pre-selected after the analysis of titles and abstracts. Then, 90 were excluded due to lack of appropriateness after reading the full-texts, thus yielding a total of 77 studies. Discussion: Risk of respiratory disease should be screened at least every 12 months based on the following criteria: a hospital admission for respiratory illness in the past 12 months; a Gross Motor Function Classification System level V; a Eating and Drinking Ability Classification System level III–V. The screening aims to lead to early diagnosis and treatment, and consists in actively evaluate the risk factors for emergency department visits and hospital admissions. A Gross Motor Function Classification System level V is the strongest predictor, but dysphagia and seizures are the strongest potentially modifiable factors. Aspiration pneumonia is the main cause of death. The main risk for aspiration are dysphagia; uncontrolled seizures; gastroesophageal reflux disease; and drooling. Other comorbidities should also be actively screened: undernutrition; tone disorders; skeletal malalignment; upper respiratory obstruction; airway clearence impairment; and restrictive lung disease. Conclusion: Respiratory impairments in CP results from a complex multifactorial process influenced by several interrelated pathophysiological factors, directly and indirectly influenced by other common comorbidities in CP. Active and early surveillance, diagnosis and treatment, involving multiple medical specialties and rehabilitation professionals is essential for success in improving the quality of life and reducing morbidity and mortality of these patients.