Major risk factors for stillbirth include lack of skilled birth attendants, low socioeconomic status, poor nutrition, prior stillbirth, advanced maternal age, and the lack of prenatal care [1]. The World Health Organization has published a prenatal care model that includes 4 routine visits for women with no specific risk condition or risk factor, and additional visits for women with health problems or risk factors [2]. During these visits, risk factors should be ascertained (e.g., syphilis screening, measurement of blood pressure) and treatments administered (e.g., iron supplementation). In Peru, the Ministry of Health recommends a schedule of 6 routine prenatal care visits with a series of assessments or interventions to be performed at specific visits [3]. However, for various reasons, the availability, accessibility, and utilization of prenatal care services may be less than optimal. In order to best inform prenatal care services in the Amazon region of Peru, where poverty remains high, we sought to identify risk factors associated with stillbirth in women delivering at the Hospital Iquitos "César Garayar Garcia" in Iquitos, the capital city of Loreto.Data were obtained from a cohort study of birth outcomes, where a random sample of mother-baby medical records had been drawn from the hospital birth registry [4]. Demographic information, admission diagnosis, observations during delivery, and discharge diagnosis were abstracted. Gestational age was determined from date of last menstrual period (LMP). If this information was missing, the gestational age recorded at admission was used; women were excluded from the study if both LMP and gestational age were missing. We also excluded women whose pregnancy was shorter than 28 weeks and those with no information on prenatal care.Two separate analyses were carried out: (1) to examine the association between having completed the recommended number of prenatal care visits according to gestational age and the risk of stillbirth, using all neonates as the denominator; and (2) to examine the association between the number of visits completed and the risk of stillbirth, using those babies born between 36 and 40 weeks of gestation whose mothers should have had 5 prenatal care visits (according to the Ministry of Health's recommendation) as the denominator. Odds ratios and 95% confidence intervals were computed from logistic regression analysis. Factors showing an association with stillbirth in simple regressions at P b 0.10 were included in multiple regression analysis. Final models included variables that were statistically significant at P b 0.05. A parity variable was also included because of its confounding effect on the association between maternal age and the risk of stillbirth.The protocol was approved by the Research Ethics Committee of the Research Institute of the McGill University Health Centre and by the Comité de Bioética of the Hospital Iquitos.A total of 4220 mothers were included. Of these, 6% had had no prenatal care visit at all during their pregnancy. The p...