Endangered and Protected Medicinal Plants in Forest Ecosystems: Diversity, Conservation Status, Therapeutic Potential, and Management Strategies.

The evidence has been mounting for decades: Extreme heat exposure increases pregnancy‐related risks for mothers and babies. In a changing climate, extreme heat exposure is increasing and will continue to increase worldwide. Low‐income countries are disproportionately affected due to high maternal and neonatal mortality and pronounced vulnerability to climate change effects. Despite the evidence on heat‐related risks during pregnancy, however, clear messages are not yet communicated to the global public in a way that can help them to recognize and reduce their risks. Strengthening the evidence base and improving risk communication remain urgent needs to help to prevent heat‐related mortality and morbidities. Heat exposure is associated with obstetric complications affecting both mother and offspring, including preterm birth, stillbirth, miscarriage, congenital anomalies, gestational diabetes, gestational hypertension and preeclampsia, cardiovascular events, placental abruption, and premature rupture of membranes [, , ]. Heat exposure is also associated with neonatal complications, including fetal distress, fetal growth restriction, and low birth weight []. The strength of evidence for these identified associations varies []. Published methodologies and study designs are heterogeneous, with differing definitions for extreme heat. While more work is needed to examine the mechanisms through which heat exposure affects pathophysiology in pregnancy, it appears that heat exposure can explain variations in maternal and perinatal mortality at the population level []. Three critical factors drive vulnerability during heatwaves. First, thermoregulation is the critical ability to maintain an internal core body temperature within a narrow, healthy range irrespective of surrounding environmental temperature. Thermoregulation is known to be difficult for people who are very young (infants) or very old (elderly) and for people who are pregnant. Second, heat exposure interacts with underlying conditions, including psychiatric and neurologic disorders, diabetes, cardiovascular disease, respiratory disease, and kidney disease [, , ]. In already compromised cardiovascular and respiratory systems, extreme heat may trigger acute health crises. Third and finally, socio‐economically marginalized people experience disproportionate exposure to heat and limited access to thermally safe spaces and health care. This includes outdoor workers and people experiencing limited mobility, social isolation, displacement, or unstable housing [, ]. Such risks will be greatest in populations that experience substantial wealth inequalities and/or complex humanitarian emergencies.