Cindy Ferreira Lima

Dr. Cindy Ferreira Lima

orcid

Research Focus & Metrics

Academic Career Length

18Years (2009-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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GSGustavo Gonçalves dos Santos
Gustavo Gonçalves dos Santos
Anuli NjokuAnuli Njoku
Anuli Njoku
RMReginaldo Roque Mafetoni
Reginaldo Roque Mafetoni
CSClara Fróes de Oliveira Sanfelice
Clara Fróes de Oliveira Sanfelice
ANAna Izabel Oliveira Nicolau
Ana Izabel Oliveira Nicolau
GVGiovana Aparecida Gonçalves Vidotti
Giovana Aparecida Gonçalves Vidotti
Background: Maternal mortality in Brazil remains a critical indicator of social and racial inequalities, reflecting structural failures in access to and quality of obstetric care. Black women, particularly those categorized as black or brown, are at a higher risk of dying during pregnancy, childbirth, or the postpartum period. This is the result of the intersection of institutional racism, poverty, and social vulnerabilities. This study aimed to analyze trends and associated factors of maternal mortality among black women in Brazil from 2000 to 2020. Methods: This is a retrospective cohort analytical study using data from the Brazilian Mortality Information System. The sample included women aged 10 to 49 years whose underlying cause of death was classified under ICD-10 codes O00–O99. Descriptive and bivariate analyses were conducted, as well as Poisson and multinomial logistic regressions to estimate adjusted risk ratios according to skin color, education, region, type, and place of death. Results: A total of 40,907 maternal deaths were identified, with 59.2% occurring among black women. The maternal mortality ratio was 39% higher among black women compared to white women and more than double among Indigenous women. Low education, residence in the North and Northeast regions, deaths outside hospital settings, and lack of formal investigation were independently associated with increased risk. Direct obstetric causes accounted for most deaths, with hypertensive disorders and puerperal complications being the leading conditions. Conclusions: Maternal mortality among black women in Brazil reveals deep structural inequalities. Urgent public policies that incorporate an intersectional perspective, addressing race, gender, and class, are necessary to reduce disparities and ensure equitable and dignified maternal healthcare.

13 October 2025 in Preprints.org
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GSGustavo Gonçalves dos Santos
Gustavo Gonçalves dos Santos
Anuli NjokuAnuli Njoku
Anuli Njoku
RMReginaldo Roque Mafetoni
Reginaldo Roque Mafetoni
CSClara Fróes de Oliveira Sanfelice
Clara Fróes de Oliveira Sanfelice
ANAna Izabel Oliveira Nicolau
Ana Izabel Oliveira Nicolau
GVGiovana Aparecida Gonçalves Vidotti
Giovana Aparecida Gonçalves Vidotti
Background: Maternal mortality in Brazil remains a critical indicator of social and racial inequalities, reflecting structural failures in access to and quality of obstetric care. Black women, particularly those categorized as black or brown, are at higher risk of dying during pregnancy, childbirth, or the postpartum period. This is the result of the intersection of institutional racism, poverty, and social vulnerabilities. This study aimed to analyze trends and associated factors of maternal mortality among black women in Brazil from 2000 to 2023. Methods: This is a retrospective cohort analytical study using data from the Brazilian Mortality Information System. The sample included women aged 10 to 49 years whose underlying cause of death was classified under ICD-10 codes O00–O99. Descriptive and bivariate analyses were conducted, as well as Poisson and multinomial logistic regressions to estimate adjusted risk ratios according to skin color, education, region, type, and place of death. Results: A total of 40,907 maternal deaths were identified, with 59.2% occurring among black women. The maternal mortality ratio was 39% higher among black women compared to White women and more than double among Indigenous women. Low education, residence in the North and Northeast regions, deaths outside hospital settings, and lack of formal investigation were independently associated with increased risk. Direct obstetric causes accounted for most deaths, with hypertensive disorders and puerperal complications being the leading conditions. Conclusions: Maternal mortality among black women in Brazil reveals deep structural inequalities. Urgent public policies that incorporate an intersectional perspective, addressing race, gender, and class, are necessary to reduce disparities and ensure equitable and dignified maternal healthcare.
1

31 December 2022 in Revista Gestão & Políticas Públicas
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Cindy Ferreira LimaCindy Ferreira Lima
Cindy Ferreira Lima
MBMarcelo Brito
Marcelo Brito
ECEdemilson Antunes de Campos
Edemilson Antunes de Campos
NNNadia Zanon Narchi
Nadia Zanon Narchi
A criação do Sistema Único de Saúde (SUS), representou grande avanço no combate à epidemia de HIV/AIDS. Porém, com a vigência do atual governo, pautado em uma política neoliberal que prioriza a adoção de medidas de austeridade econômica, em detrimento do investimento em políticas de bem-estar social, observamos o agravamento de sua precarização e desconstrução. À epidemia de HIV/AIDS, por sua vez, tem fortes conexões com as desigualdades socioeconômicas e histórico-culturais, que corrobora maior incidência em indivíduos com alta vulnerabilidade socioeconômica, dependentes da assistência do Estado. Neste ensaio, buscaremos analisar o tema sob a luz dos estudos de Biopolítica, iniciados por Michel Foucault a fim de refletir sobre o impacto das restrições orçamentárias, sobre a sustentabilidade da assistência à saúde de Pessoas Vivendo com HIV, assim como das políticas públicas vigentes. Nesta ótica, suscitamos a urgência da articulação política da população em defesa da sustentabilidade do SUS, de modo sua garantir permanência e dos programas vigentes, como o programa de HIV/AIDS. Acreditamos que somente através da articulação da sociedade civil, em parceria com atores situados em instâncias políticas decisórias e em prol da sustentabilidade do SUS, será possível manter o direito universal e inalienável à saúde, descrito na Constituição Federal.

11 November 2025 in Nursing Reports
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GSGustavo Gonçalves dos Santos
Gustavo Gonçalves dos Santos
GVGiovana Aparecida Gonçalves Vidotti
Giovana Aparecida Gonçalves Vidotti
CICarolliny Rossi de Faria Ichikawa
Carolliny Rossi de Faria Ichikawa
Cindy Ferreira LimaCindy Ferreira Lima
Cindy Ferreira Lima
LDLeticia Dionizio
Leticia Dionizio
LETICIA LÓPEZ-PEDRAZALETICIA LÓPEZ-PEDRAZA
LETICIA LÓPEZ-PEDRAZA
Background: Maternal mortality remains a significant public health challenge in Brazil, reflecting persistent social, racial, and regional inequalities. Objectives: This study aimed to analyze trends and characteristics of maternal deaths in Brazil from 2000 to 2020, identifying sociodemographic and clinical risk factors. Methods: A retrospective, population-based study was conducted using secondary data from the Sistema de Informações sobre Mortalidade (SIM) of the Brazilian Ministry of Health. Descriptive and comparative statistical analyses were performed, including chi-square (χ2) goodness-of-fit tests and 95% confidence intervals calculated by the Wilson method. Variables were stratified by region, age, race, education, type and period of death, and investigation status. Results: A total of 40,907 maternal deaths were recorded. From 2000 to 2020, Brazil recorded 40,907 maternal deaths. The maternal mortality ratio decreased from approximately 74 deaths per 100,000 live births in 2000 to 57 per 100,000 in 2020, representing a 23% reduction over two decades. Most deaths occurred among young, Brown women with low education levels, particularly in the Southeast and Northeast regions. Direct obstetric causes accounted for two-thirds of cases, and most deaths occurred in hospital settings, mainly during the early puerperium. Conclusions: Despite progress, maternal mortality in Brazil remains above the WHO target and is strongly influenced by social inequities. Strengthening primary care, improving referral networks, expanding postpartum follow-up, and enhancing surveillance systems are essential for preventing avoidable deaths and achieving reproductive justice.

1 September 2009 in Fertility and Sterility
Verified
Journal Article
Closed access
RFR.M. Fariello
R.M. Fariello
JPJ.R. Pariz
J.R. Pariz
Cindy Ferreira LimaCindy Ferreira Lima
Cindy Ferreira Lima
DSD.M. Spaine
D.M. Spaine
RBR.P. Bertolla
R.P. Bertolla
ACA.P. Cedenho
A.P. Cedenho

10 June 2026 in Epidemiologia
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Journal Article
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GSGustavo Gonçalves dos Santos
Gustavo Gonçalves dos Santos
Anuli NjokuAnuli Njoku
Anuli Njoku
AMAna Carolina Pereira Mass
Ana Carolina Pereira Mass
EREllen Eduarda Santos Ribeiro
Ellen Eduarda Santos Ribeiro
LOLetícia Eduarda de Oliveira
Letícia Eduarda de Oliveira
ICIsabelle Cristinne Pinto Costa
Isabelle Cristinne Pinto Costa
Background: Maternal mortality remains a major global health challenge, disproportionately affecting black and Indigenous women. Hypertensive disorders of pregnancy and postpartum hemorrhage are the leading direct causes of maternal death. Artificial intelligence (AI) tools have emerged as potential strategies for predicting these complications, yet concerns persist about their equity and validation across racial groups. Methods: A rapid review was conducted in five databases, PubMed, EMBASE, Web of Science, Scopus and LILACS, to synthesize recent evidence on the use of AI for preventing maternal mortality due to hypertension and postpartum hemorrhage. Studies published in the last five years that included racial or ethnic data were selected and analyzed narratively. Results: Ten studies met the inclusion criteria, showing high predictive accuracy of AI models (AUROC often >0.95) for severe maternal outcomes. However, few models incorporated racial variables or underwent external validation in racially diverse or low-resource populations. Evidence suggests that unrepresentative datasets may perpetuate or exacerbate existing health inequities. Conclusions: AI demonstrates strong technical performance in predicting maternal complications but limited equity in application. Broader racial representation, external validation, and ethical governance are essential for ensuring that AI-based tools reduce rather than reinforce racial disparities in maternal mortality.