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Abstract
Neonatal mortality accounts for a growing proportion of under-five deaths worldwide, yet sub-national data remain limited. This study estimated neonatal and perinatal mortality rates (NMR, PMR), causes of death, and risk factors in nine villages in Loreto Province, Peru. Using five-year pregnancy histories and WHO verbal autopsy, NMR was 31.4/1000 live births and PMR 49.7/1000 pregnancies—among the highest reported in Peru. Infection and asphyxia were leading causes of neonatal death. Risk factors included twin gestation, preterm delivery, and cesarean section. Findings underscore the need for targeted interventions and improved maternal-child health strategies in rural Peruvian communities.