Costa is particularly excited about the role biomarkers could play in improving the diagnosis and management of preeclampsia.

She believes point-of-care tools that provide results quickly could help clinicians make more timely decisions about hospital admission and patient transfer, including in low-income settings.

“I am really excited about the role of using biomarkers to improve diagnosis and management of preeclampsia.”

She currently has several studies underway involving different types of biomarkers. She is also working on training healthcare workers to use interventions that are already established in clinical guidelines but can be difficult to implement, including the use of magnesium sulfate in primary care.

Her team is working with Brazil’s Ministry of Health with the goal of implementing this training across the country.

Costa is also deeply interested in the placenta. At her university, she established the first placental biobank in Brazil. Her research includes placental morphology, gene expression, and conditions associated with preeclampsia or an increased risk of preeclampsia, including COVID-19, sickle cell disease, and autoimmune disease.

Costa describes her interest as a combination of personal experience and her academic work.

Her grandmother developed severe preeclampsia during her final pregnancy at age 42. Costa grew up hearing about the complications her grandmother experienced, including significant swelling and a lack of adequate antenatal care.

“I heard that story since I was young, of the complications she had, how she was swelling, and how she didn’t have adequate antenatal care.”

Later, during her master’s and PhD work on maternal morbidity, she saw the continued burden of preeclampsia and eclampsia in Brazil.

Recognizing that these conditions remain responsible for hundreds of maternal deaths in the country each year, and that many of those deaths are avoidable, led her to make hypertensive disorders of pregnancy a research priority.

Costa describes her feelings about the field’s progress as mixed.

Although she has studied maternal morbidity for approximately 20 years, she notes that maternal mortality outcomes in her setting have not improved as much as she had hoped.

“I’ve been studying this for around 20 years, but without impact in outcomes so far.”

At the same time, she points to several areas of significant progress:

• Greater understanding of how preeclampsia develops
• Improved knowledge of biomarkers
• Changes in how the condition is diagnosed
• Stronger evidence that adequate diagnosis and management can reduce mortality

She notes that the field has made less progress in the availability of treatments and medications, but she believes that could change during the next decade.

Rather than identifying one major discovery, Costa emphasizes the importance of research that can be translated into meaningful improvements in care.

Her work has contributed to research on the epidemiology of maternal morbidity, conditions associated with preeclampsia and worse outcomes, and the relationship between COVID-19, preeclampsia, and biomarkers.

A conversation with her daughter also changed how she thinks about scientific discovery. After Costa returned from two years of postdoctoral training at Washington University in St. Louis, her seven-year-old daughter asked her a simple question:

“If you are a researcher, what have you discovered?”

The question challenged Costa to explain the meaning of her research in language that a child could understand.

Since then, she has encouraged her students to explain what they discovered through each project clearly enough for a seven-year-old to understand.

One of the greatest challenges is ensuring that research reaches the healthcare settings that need it most.

Costa works in a referral center where biomarkers, intensive care, and other technologies are available. However, she emphasizes that this is not the reality throughout Brazil.

“I really hope that the research that we perform really gets into those settings that most need it.”

Because Brazil is a country of continental size, maternal health conditions and mortality rates vary across regions. The realities of the southeast can differ significantly from those of the north and northeast.

Costa believes that different settings require different strategies. International research and guidelines should include the perspectives of places facing the greatest burden while accounting for healthcare restrictions, limited resources, and delays in care.

For Costa, her involvement with ISSHP is one of the most meaningful parts of her professional journey.

As ISSHP Global Chair, she is honored to represent low- and middle-income countries and values the opportunity to work with researchers and clinicians from around the world.

“It is amazing to be able to be at a table with researchers from all around and have everyone respect each other and be interested in understanding the reality of others and working together to improve care.”

She values ISSHP as a committed group whose members seek to understand different healthcare realities and work collaboratively to improve care.

Costa encourages young researchers to consider the potential impact of their work whenever they develop a research question or begin a new project.

“Every time you have a research question or write down a project, you should think of the impact that research can have.”

Even when research is conducted in a laboratory, she believes the ultimate goal should remain improving maternal health.

She also encourages researchers to think about how their findings will be communicated to patients and society.

Costa is motivated by the possibility of reducing avoidable maternal deaths and ensuring that research improves care in the communities with the greatest need.

Her clinical experience and international collaborations have shown her how differently preeclampsia can affect outcomes across healthcare settings.

“Avoidable mortality is unacceptable.”

In some settings, preeclampsia continues to cause hundreds of maternal deaths, while deaths from the same condition have become rare elsewhere.

This inequality drives her commitment to international collaboration and research that reflects the realities of both well-resourced and lower-resource healthcare systems.

Outside of medicine and research, Costa is an enthusiastic sports fan.

She plays on her hospital’s soccer team, plays volleyball at her children’s school, and practices tennis.

“If you turn on any sports on TV, I’ll stop to watch.”

Whether she is participating herself or watching on television, sports remain an important interest outside of her work.