AimsTo assess the safety of buprenorphine compared with methadone to treat pregnant women with opioid use disorder.MethodsWe searched PubMed, Embase and the Cochrane Library from inception to February 2015 for randomized controlled trials (RCT) and observational cohort studies (OBS) that compared buprenorphine with methadone for treating opioid‐dependent pregnant women. Two reviewers assessed independently the titles and abstracts of all search results and full texts of potentially eligible studies reporting original data for maternal/fetal/infant death, preterm birth, fetal growth outcomes, fetal/congenital anomalies, fetal/child neurodevelopment and/or maternal adverse events. We ascertained each study's risk of bias using validated instruments and assessed the strength of evidence for each outcome using established methods. We computed effect sizes using random‐effects models for each outcome with two or more studies.ResultsThree RCTs (n = 223) and 15 cohort OBSs (n = 1923) met inclusion criteria. In meta‐analyses using unadjusted data and methadone as comparator, buprenorphine was associated with lower risk of preterm birth [RCT risk ratio (RR) = 0.40, 95% confidence interval (CI) = 0.18, 0.91; OBS RR = 0.67, 95% CI = 0.50, 0.90], greater birth weight [RCT weighted mean difference (WMD) = 277 g, 95% CI = 104, 450; OBS WMD = 265 g, 95% CI = 196, 335] and larger head circumference [RCT WMD = 0.90 cm, 95% CI = 0.14, 1.66; OBS WMD = 0.68 cm, 95% CI = 0.41, 0.94]. No treatment differences were observed for spontaneous fetal death, fetal/congenital anomalies and other fetal growth measures, although the power to detect such differences may be inadequate due to small sample sizes.ConclusionsModerately strong evidence indicates lower risk of preterm birth, greater birth weight and larger head circumference with buprenorphine treatment of maternal opioid use disorder during pregnancy compared with methadone treatment, and no greater harms.

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Over the past thirty years, geoarchaeology has moved from the fringe to mainstream status within Mesoamerican archaeological investigations. This review focuses on works published since the year 2000. Five themes are identified as central to recent studies: (1) the correlation of environmental change and cultural history; (2) anthropogenic environmental impacts; (3) ancient land cover, land use, and diet; (4) archaeological prospection; and (5) provenance studies. These themes are often interwoven in the application of complex systems approaches that allow scientists to more accurately model the intricacies of ancient human-environment interactions. C 2015 Wiley Periodicals, Inc.

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retrieved from the right neck incision. Once adequate alignment was confirmed, the zone 0 TBE was deployed. The innominate artery branch component (20 mm  12 mm  6 cm) was delivered and deployed in standard fashion. Completion angiography demonstrated no evidence of endoleak. He was subsequently discharged in good condition.Conclusions: Treatment of high-risk patients with type A aortic dissection presents a surgical challenge. Endovascular treatment with branched devices may provide a suitable alternative to open repair in this patient population.